Official Georgia ACDIS Membership Registration for 2026
We are honored you want to become a member of Georgia Chapter of ACDIS for 2026.

Please note the state chapter membership is separate from the national ACDIS membership, but state chapter members get a discount to national membership after step 3.

There are (3) three steps to become and official paid member of Georgia ACDIS:

     1) Complete this registration form for chapter membership registration 
     2) After this form submission, pay annual chapter dues of $25.00 via CashApp or by check
     3) Complete the national ACDIS chapter roster **
     4) Optional - Join WhatsApp community group conversation on your smartphone
                  **(the link will be provided after submission of this form).

Please note, it is important to not go to the click on the outside web links until after this form submission. When changing pages during this form mid-process, your information could disappear. It is suggested to copy and paste the links in another browser window instead of clicking link for this form.

 ** Special deal for Georgia ACDIS members to join national ACDIS. Once you complete the national roster for Georgia in step 3 from the link to national ACDIS website, note there is a discount code for going the national membership. 

It is encouraged but not required for Georgia Chapter members to also join national ACDIS.

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Email *
First Name *
Last (sur) Name *
Cell or Home Phone Number ( 10 digits ) *
Department *
Affiliation (Hospital or Organization)
Email - Personal email preferred to prevent facility firewalls from blocking our emails sent from Google Gmail. *
Secondary email as a backup.
Do you know someone or yourself who would like to present at a state chapter meeting? If yes, please let us know and provide their contact information.
Next step is to submit payment for annual dues.
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