ALSAM Application

Select An Option

ALSAM Associate Membership

Non-Physician clinicians who work in the addiction medicine space.

ALSAM Early Career Membership

Physicians working in addiction medicine within the first 8 years of practice.

ALSAM Regular Membership

Physician membership

ALSAM Resident Membership

Residents in Alabama participating in a residency program with an interest in addiction medicine, or an addiction medicine fellow.

ALSAM Retired Membership

Physicians who are retired but have worked in the addiction medicine space.

ALSAM Student Membership

Students in a MD/DO medical school in Alabama interested in addiction medicine.

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

Membership Options are incorrect, Please check the selected membership options