AAGP Member Account Registration

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Founded in 1978, the AAGP provides psychiatrists and health care professionals with a special interest in mental health care of the elderly exceptional professional benefits through educational, informational, and interactive programs. This application will be reviewed and voted upon by the AAGP Board of Directors (Board approval of new membership takes 3-4 weeks).

AAGP membership is based on the calendar year (January - December) and ends on December 31 of each year.

Prefix: First Name: Middle Name: Last Name: Suffix: Degree: Primary Email: Secondary Email: Primary Phone#: Secondary Phone#: Birth Date(MM/DD/YYYY): / / Gender: Which of the following best describes your racial or ethnic identification? Prefer to self-describe your racial or ethnic identification: Language Language - If Selected Other Mailing Street Address: City: State: Zip: - Country: Company: Job Title: Please confirm your profession: Work Setting (Check all that apply) Are you:

Early Career Psychiatrist (First 7 years since training)

International Medical Graduate

I am both IMG and ECP

Not Applicable

Describe how your work relates to mental health Percentage of work with the elderly Board Certified

Yes

Please specify Board certifications you have received Do you accept Referrals Professional Membership(s) held How did you hear about AAGP? Referred Name and Email:

To manage your AAGP account (i.e., join committees, update profile, etc.), please create a login name and password below. Your password must be at least eight characters long, and contain at least one number.