Associate Members

- Membership Brochure & Reg. Form. (PDF)
- On-line Registration Form

HFAM created this category of membership for individuals and companies that supply goods or services to health care facilities, or that have a professional interest in long-term health care.

Associate Members benefit HFAM in many ways. Their dues help support HFAM’s programs and services. Their expertise and experience help provider-based members make more informed choices when purchasing goods and services.

In return, Associate Members receive many benefits, including access to their best customers, access to the latest information on laws and regulations affecting long-term health care facilities, and recognition as one of the leading suppliers of goods and services to the health care industry.

On-line Registration Form

I/we hereby make application for Associate Membership in the Health Facilities Association of Maryland and agree, if accepted, to abide by the Constitution and Bylaws, support the Association's goals and objectives, and pay the established dues in a timely manner.

Company/Org./Individual:

Check One:

	Corporation
	Professional Org.
	Sole Proprietorship
	Partnership L.L.C.
	L.L.P
Other:

Address:

City, State, Zip:

Phone:

Fax:

Web Site:

Contacts: Provide up to five representatives whom you wish to receive information and be listed in HFAM's Membership Directory.

Name:

Title:

Phone:

E-mail:

Name:

Title:

Phone:

E-mail:

Name:

Title:

Phone:

E-mail:

Name:

Title:

Phone:

E-mail:

Name:

Title:

Phone:

E-mail:

Does your company belong to any other healthcare related orgs.?

Yes
No
If yes, please list:

Does your company have an ownership or management interest in any nursing facility or other associate company?

Yes
No
If yes, please list:

Payment:

Membership Dues are $950 (prorated) per calendar year.

Check:
	Mail to: HFAM 7135 Minstrel Way, Suite 104 Columbia, MD 21045
Credit Card: We use Secure Socket Layer encryption technology (SSL) to protect your online order. SSL encrypts all of your information so it cannot be read when sent over the Internet.
Card #:
Expiration Date:
Cardholder Name:
Address:
City, State, Zip