Become A Member

Please note that the Membership is based on the calendar year (January 1st -December 31st). We do not prorate.

* Required field

CASEM Membership

Membership

Account

Email*

Password*

Confirm Password*

Membership

First Name*

Last Name*

Preferred Language

Gender

Female

Male

Clinic

Address*

Unit # or P.O. Box

City*

Country*

Province/ State

Postal Code*

Phone*

Work Phone

Extension

Fax

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Type of Practice

The Canadian Academy of Sport Medicine provides the names of physicians interested in sport medicine to National Sport Organizations for involvement in the medical care of athletes and sport coverage. If you are willing to have your name forwarded to these organizations, please indicate the sports you would like to work with.

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Sports Interests

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Please indicate which committees you would be interested in:

CASEM Committees

Comments

*New Members must input their license number in order for Head Office to process their application*

Licence Number

I certify that I am a physician licensed to practice in the province and or country indicated in my membership application.

Membership will be rendered invalid without refund or compensation of membership dues, if false information is provided. Membership will be activated once copy of medical license or medical school registration is received at the National Office. A subscription to the Clinical Journal is NOT included with the student membership fee.