Friends of Medicine

Membership Inquiry Form

Friends of Medicine is a private, members-only professional network connecting elite healthcare and business professionals across the United States.

This inquiry form is the first step in our membership review process. Completion of this form does not guarantee acceptance. Additional membership benefits, access tiers, and privileges are shared only with applicants who are invited to proceed to the application stage.

Full Name *

Last Name *

Phone *

Email *

Industry *

LinkedIn *

Current Professional Role/Title *

Organization/Practice Name *

Years of Experience in Healthcare *

Please provide at least one active professional or business profile. *

Brief description of why they're interested in FOM membership *

How did you hear about Friends of Medicine? *

Have you attended any FOM events? (If yes, which ones?) *

Which membership are you interested in?