Active Member Active Members are physicians (MD, DO, DPM) who dedicate at least a portion of their practice to orthobiologic medicine. 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City, State, Zip is Required Website:* Website is Required Email Contact :* Email Contact is Required Gender:* Gender is Required Male Female Degree(s):* Degree(s) is Required MD DO DPM PhD Fellow Other Mobile Number:* Mobile Number is Required Physician's State Lic#:* Physician's State Lic# is Required Practice Specialization :* Practice Specialization is Required Physical Medicine & Rehabilitation Family Medicine Sports Medicine Interventional Pain Orthopedics Podiatry Other Principal Practice Setting:* Principal Practice Setting is Required Single Specialty Group Hospital Academic Hospital Community Research Military Multispecialty Group Solo Provider Other Areas of Practice (Check as many as applies):* Areas of Practice (Check as many as applies) is Required Stem Cell Joint Therapy Platelet Rich Plasma Treatments Spine Treatments Regenerative Medicine Other Topics/Areas of Interest :* Topics/Areas of Interest is Required Ankle & Foot Knee Neck Low Back Hip Hand & Wrist Elbow Shoulder How did you hear about IOF?:* How did you hear about IOF? is Required I hereby consent to the release by any hospital, educational institution, governmental agency, physician, professional society, or other person posessing or requiring the same whether or not listed above, of any and all information in any way pertaining to my personal character, training, experience, or professional competence. I hereby release from any liability the Interventional Orthobiologics Foundation and any and all individuals for their acts performed in good faith in connection with evaluating my application and my credentials and qualifications. I hereby certify that all information recorded on this application and any attached documents are accurate and support my qualifications for membership in the Interventional Orthobiologics Foundation for which I now apply. I hereby agree that Interventional Orthobiologics Foundation may verify any of the above data. I hereby understand that my payment today is non-refundable, to cover processing fees and immediate initiation of membership.* Username:* Invalid Username Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Have a coupon? Coupon Code: Invalid Coupon No val Please fix the errors above