Active Membership

All information "except address and location" will be searchable and visible to BPS members and staff.

Disclaimer

* First Name

* Last Name

Biography

* Email Address

Profile Display Name

* Password

Strength: Very Weak

Profile Picture / Avatar

Drop file here or click to select.

Profile Cover

Drop file here or click to select.

Contact Info

* Contact - Address

Contact - Address 2

* Contact - City

* Contact - State

* Contact - Zip Code

Contact - Country/Region

Practice & Specialties

* Practice Type (CLICK ALL THAT APPLY)

* Specialty

* Degree

Rank / Position

Med School/ Professional school

Residency

Fellowship

Interests

Committee Preference (CLICK ALL THAT APPLY)

Area of clinical/research

Would you like to be a mentor

Yes

No

Practice Information (This is your public face)

Information under "Practice Information " section will be public and searchable. You are encouraged to add this information to the extent you want to improve visibility of your practice to the public and patients.

Practice Name

Practice Specialty

Types of conditions or procedures

Practitioner/Practice Biography

Practice Address

Practice Address 2

Practice City

Practice State

Practice Zip

Practice Country

Website (URL)

Practice Phone

Social Profiles

Copy the URL from your social media platform member page.

Doximity

Active Member

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