Membership Application

Instructions

MEMBERSHIP REQUIREMENTS:

Complete the Membership Election Form and Attestation.
Promptly advise APA of any governmental inquiries.
Respond to BBB and similar consumer complaints.
Comply with all applicable state and federal statutes and regulations, including those regarding medical funding.

MEMBERSHIP BENEFITS

Americans for Patient Access (“APA”) appreciates your interest in becoming a member. The following summarizes the benefits of APA Membership. If accepted, your membership is valid and is contingent upon adherence to all requirements laid out within this document.
- Real-time updates on all relevant legislation impacting medical lien funding nationwide;
- Direct input in legislative planning and strategy;
- Opportunities to consult with relevant lobbyists, and legislative leaders; and
- Participation in APA meetings and events.

Select An Option

Associate - Vendor or Other Consumer Financial Organization

Select Level

Associate - Medical Provider

Select Level

Factoring Organizations

Select Level

Non-Member Advocacy Partner

Please contact APA for how you can assist advocacy efforts by making political contributions, testifying at legislative hearings, meeting with lawmakers in person, and other ways you can support advocacy efforts.

Associate - Legal Affiliate

Select Level

Legal Affiliate

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