Paper application
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Discounted membership rates for group practices and organizations Learn more
Paper Application Print and complete an application form, then mail or fax it to RIMS.
Get Application Form
Mail to: Rhode Island Medical Society 235 Promenade Street, Suite 500 Providence RI 02908
Fax to: 401-751-8050
Apply Online
Personal information supplied will be used for RIMS internal purposes only, and for RIMS correspondence and mailings to you.
Practicing physicians' offices addresses and specialtiies will be published in RIMS' annual Membership Directory.
xPlease complete all relevant fields
First name
Last name
Degree(s)
Date of birth
xOffices and Specialties will be published in RIMS' Membership Directory. xIf you have more than two office locations send details in an email to Sarah Stevens.
Primary office address
Office phone
Office fax
Second office address
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Specialty
Board Certified
Yes
No
Secondary specialty, if any
xPersonal information is for RIMS correspondence with you. It will not be made public.
Preferred email address
Home address
Home phone
Spouse's name
Is your spouse a physician?
Your Medical School
Year of Graduation
Preferred mailing address
Office
Home
xOR preferred mailing address to receive each of the following:
Medicine & Health RI magazine
RI Medical News newsletter
Membership dues billing
xMany patients call RIMS looking for a new doctor. xDo you want RIMS to refer such callers to you?
Choose a Membership Category
You will be billed following your acceptance.
$475
Full membership
$250
Spousal discount, for second RIMS member
Free
First year of practice
$100
Second year of practice
$200
Third year of practice
$300
Fourth year of practice
Part time, practicing 20 hours or less per week
$40
Resident, PGY of
Fellow, Year of
$110
Military, in uniform
$50
Affiliate
Physician Assistant
Retired
Medical student
Has your application for membership in any medical society ever been disapproved, or have you ever been suspended or expelled from membership in any medical society? Has your license to practic medicine ever been revoked? Have you ever been convicted of a felony?
If you answer "yes" to any of the above questions, please provide details in a separate letter and mail it to:
RIMS Membership Committee 235 Promenade Street, Suite 500 Providence RI 02908
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Updated 3/6/08
