Please complete the following form to apply for membership into PAD. Do not send payment for membership dues with this application. You will be billed upon enrollment as a member and dues are payable within 60 days after billing. Applications are acted upon by the Membership Committee of the Academy. Applicants will be notified of their application status within 30 days following the Committee’s decision.

Membership Level

Fellow - $250 (USD)

Early Career Physician - Year 1 - $75 (USD)

Early Career Physician - Year 2 - $125 (USD)

Early Career Physician - Year 3 - $200 (USD)

Fellow in Training - Free, sponsor not required - $0 (USD)

Setup Username and Password

Please enter MEMBER email address

Password must be at least 6 characters long

Contact Details

Enter your first name as you would like it shown in communications

Include Member Directory Email on notifications
Include my information in the Member Directory
Add Administrator Details

Educational Credentials

Professional Credentials

I understand by becoming a member of PAD I am granting permission to PAD to send emails to the contact email associated with my membership