OEIS Membership Application | Outpatient Endovascular and Interventional Society

Membership Information

You have selected the Active Member membership level.

This is for the membership level Active Member.

The price for membership is $350.00 per Year.

Do you have a discount code?

Account Information

Username

Password

Confirm Password

First Name

Last Name

Email Address

Confirm Email Address

Full Name LEAVE THIS BLANK

Already have an account? Log in here

Choose a Path to Active Membership and Your Preferred Support Method

On the previous page we discussed three paths to Active Membership. As a reminder...

PATH 1: Membership will be considered for physicians who perform procedures in outpatient endovascular or interventional laboratories. Candidates shall have certification by both a primary specialty board and an applicable subspecialty board which holds membership in the American Board of Medical Specialties or the Bureau of Osteopathic Specialists of the American Osteopathic Association and which have included endovascular procedures as an integral component of their training; including the fields of Vascular Surgery, Interventional Cardiology, and Interventional Radiology. Candidates should be performing endovascular and interventional procedures in an outpatient center. Lacking Board certification, candidates are expected to have made important clinical contributions over a period of years in an applicable field, and to provide evidence that he/she is recognized by peers in his/her community that he/she is a specialist.

PATH 2: Membership will be considered for physicians who: (1) belong to practices which offer outpatient endovascular or interventional procedures and (2) have at least one interventionist in their practice who is an active Member.

PATH 3: Physicians who do not clearly meet the above-stated criteria for Pathways 1 and 2 will be reviewed for membership by the Membership Committee on a case-by-case basis for possible qualification and approval by the Board.

NOTE: For avoidance of doubt, only Active Members may vote on actions required by these Bylaws to be voted on or approved by members.

CHOOSE YOUR PATH:

Path 1

Path 2

Path 3

All candidates for Active Membership, must also be supported by one of the following two methods:

A) ONE active member of OEIS must write fill out a form affirming their support for your active membership,

B) TWO physician colleagues who are not members of OEIS or your medical practice that are willing to complete a Peer Survey Form on your behalf.

NOTE: OEIS will send links to the proper forms via email. It is the responsibility of you, the APPLICANT, to contact your references to ensure that the appropriate forms were 1) received, and 2) submitted on your behalf in a timely manner. Please make certain that the email addresses of your supporter(s) are entered correctly on this form!

Please attest to the support for membership that can be offered on your behalf:

One current, active member of OEIS will fill out a support form for me.

Two physician colleagues will complete Peer Surveys on my behalf.

Please provide us with the current active OEIS member's name:

Please provide us with the current active OEIS member's email address:

Please provide us with the FIRST physician colleague's name:

Please provide us with the FIRST physician colleague's email address:

Please provide us with the SECOND physician colleague's name:

Please provide us with the SECOND physician colleague's email address:

Provide Additional Information for the Member Directory Profile

Please choose a professional suffix:

Enter your own professional suffix:

Physician NPI Number

Specialty:

What is your specialty?

Practice or Company Name:

Practice or Company Address:

City:

State:

Zip Code:

Business Affiliation:

Practice or Company Web Site:

Preferred Phone Number:

Provide Alternate Contact Information (i.e., secretary, office manager, etc.)

Alternate Contact Name:

Alternate Contact Phone Number:

Alternate Contact Email Address:

Provide a Curriculum Vitae and Answer These Questions

All Candidates for Membership must provide a current curriculum vitae or resumé. (FILE UPLOAD)

The only file formats accepted are .PDF, .TXT, .DOC, and .DOCX.

Are you a physician who belongs to a practice which offers outpatient endovascular or interventional procedures?

Yes

Does another physician in your practice already have Active Membership in the society?

Yes

Are you employed by or affiliated with a corporation that either (1) provides outpatient endovascular and interventional procedures, or (2) provides goods and services for office-based cardiovascular procedures?

Yes

Would you like to set up automatic renewals?

Yes, renew at $350.00 per Year.

Processing...