By clicking the check box below, I headby apply for membership in the Illinois Homeopathic Medical Association (IHMA).
I hereby grant permission for the IHMA and its membership committee, in the processing of this application, to obtain any information deemed necessary to evaluate my application from any of the parties or sources listed in this application.
I hereby release, and hold harmless from any liability or loss, the IHMA, its officers, agents, employees and members, for acts performed in good faith and without malice in connection with evaluating my application, credentials and qualifications and hereby release from any liability any and all individuals and organizations, who in good faith and without malice, provide information to the IHMA, or to its authorized representatives, concerning my qualifications for membership.
Further, I believe that to the best of my knowledge I have answered the above questions fully and honestly. I agree to abide by the bylaws of the IHMA, to pay all dues, fees and assessments in a timely fashion, and to conduct my practice in a ethical manner.
