Change of Component Society membership request

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Thank you so much for being a member of the Colorado Medical Society and your Component Society. Through CMS's unified membership with the Component Societies, we are honored to support the physicians of Colorado. If you wish to change your Component Society membership, you must initiate a transfer request either through the executive director of your current Component Society, if active, or through the CMS membership department using the form below. Questions? Contact membership@cms.org.

Email *

Full Name *

CMS member number or Colorado license number

Cell phone number

I am currently a member of (Component Society):

I am requesting transfer to (Component Society):

Reason (not required):

Moved practice into/out of Component Society

Moved primary residence into/out of Component Society

I practice in several locations under the jurisdiction of several component societies and have chosen the new Component Society

My assigned Component Society is inactive and I want to join an active Component Society

Difference in dues cost

Other:

Would you like CMS to contact the current and new Component Societies on your behalf?

Yes, thanks!

No, I will contact my current Component Society myself

Clear selection

Additional notes or requests:

Send me a copy of my responses.

Submit

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