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Title: M.D. Ph.D. D.O. other (specify)

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Type of Practice: Private
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Membership classifications:

Active Members $375 (SPPM/SPA Membership)

Active Members $475 (SPPM/SPA/CCAS Membership)

Physicians practicing in the US and Canada who have an interest in pediatric pain medicine, are eligible to be members of the American Society of Anesthesiologists (the "ASA"), AND are active members of the Society for Pediatric Anesthesia (SPA). Each Active Member shall be entitled to one vote on each matter submitted to the membership of the Section for a vote.

Active B Members $100 (SPPM Only Membership)

The SPPM Active B class of membership shall consist of physicians who have an interest in pediatric anesthesia and are ineligible to be members of ASA and nonphysicians who have an interest in pediatric anesthesia. Any person classified as an SPPM Active B member shall have SPPM voting privileges and shall be eligible for election to the Society’s Board of Directors

Affiliate A Members $375 (SPPM/SPA Membership)

Affiliate A Members $475 (SPPM/SPA/CCAS Membership)

Physicians practicing in the US and Canada who are ineligible to be members of ASA and persons who are not physicians, who have an interest in pediatric pain medicine, and are affiliate members of the Society for Pediatric Anesthesia (SPA). Affiliate A Members shall not be entitled to vote on any matters submitted to the membership of the Section for a vote.

Affiliate B Members $75 (SPPM Only - not eligible for SPA membership)

Physicians practicing in the US and Canada who are ineligible to be members of ASA and persons who are not physicians, who have an interest in pediatric pain medicine, but are not practicing or interested in pediatric anesthesia and are ineligible for membership with the Society for Pediatric Anesthesia (SPA).
Affiliate B members will be shown as Affiliate Members on the membership record of the Section but not on the membership record of the Society for Pediatric Anesthesia (SPA) unless they also choose to become members of SPA. Affiliate Members shall not be entitled to vote on any matters submitted to the membership of the Section for a vote.

International Members (SPPM/SPA/CCAS Membership) Tier 1 ($75) Tier 2 ($48) Tier 3 ($24) Tier 4 ($9)

Physicians practicing outside of the US and Canada who have an interest in pediatric anesthesia and pediatric pain medicine. International members will receive membership to Society for Pediatric Pain Medicine, Society for Pediatric Anesthesia and the Congenital Cardiac Anesthesia Society. The tiered dues categories are based on the World Bank of Economies. Please refer to the SPA Website to determine your tier.

Resident & Fellow Members

Resident $50 (SPPM/SPA/CCAS Membership)

Fellow $100 (SPPM/SPA/CCAS Membership)

Physicians who are in an approved residency training program, or are performing post-residency fellowship training. It shall also include trainees in other health care-related fields such as nursing, psychology or pharmacology. Members shall not be entitled to vote on any matters submitted to the membership of the Section for a vote. Resident and Fellow Members receive membership to Society for Pediatric Pain Medicine, Society for Pediatric Anesthesia and the Congenital Cardiac Anesthesia Society.

I am applying for:

Active SPPM/SPA Membership $375
Active SPA/CCAS/SPPM Membership $475
Active B SPPM Membership $100
Affiliate A SPPM/SPA Membership $375
Affiliate A SPA/CCAS/SPPM Membership $475
Affiliate B SPPM Only Membership $75
International Membership Tier 1 with SPA, CCAS and SPPM $75
International Membership Tier 2 with SPA, CCAS and SPPM $48
International Membership Tier 3 with SPA, CCAS and SPPM $24
International Membership Tier 4 with SPA, CCAS and SPPM $9
Fellow Membership $100
Resident Membership $50
      Residency:
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      Residency Completion Date:  /   / 

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Note: This is a secure transaction system. However, if entering your credit card information online makes you uncomfortable, please pay by check. Send all checks to SPPM, 2209 Dickens Road, Richmond, VA 23230-2005
Society for Pediatric Pain Medicine
2209 Dickens Rd • Richmond, VA 23230-2005
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