Service Line Membership

Instructions

Service Line Member: Eligible organizations must be engaged in the delivery of home care through certified home care, hospice, private duty home care, home pharmacy/infusion, or home medical equipment services. Each legally recognized business unit shall be eligible for a membership. For purposes of membership, each organization with a filed assumed name is considered a legally recognized business unit. Each service line membership shall have one vote in association elections. Service line members may serve on the Board of Directors, and may hold office.

Service Line Members are those who provide care through one service line. If you have multiple service lines or multiple locations, please complete the Corporate Membership application.

Minimum dues are $500 and maximum dues are $5000, per service line.

The membership year is good for one year from date of application.

If dues are owed from a prior year, payments received will apply to past dues before the renewal dues.

Renewals are organizations that have been a member in the past 5 years.

Select Your Option(s)

Service Line- Certified/Hospice/Palliative Care

Service Line- Home Medical Equipment/ Infusion

Service Line- Private Duty

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist