Join PALTC Today! - Carolinas Society for Post-Acute and Long-Term Care

Become a part of the CPALTC community by registering for membership or renewing your existing membership online. We offer a range of exclusive resources and networking opportunities to our members.

To complete the membership application, simply fill out the fields below and click submit. You also have the option to send a check to:

Physicians Eldercare
4692 Brownsboro Road
Winston-Salem, NC 27106

or pay online via PayPal.

If you have any questions or require further information about membership, please don’t hesitate to contact us at taclements@novanthealth.org. We’re always happy to help.

Membership Type *

New
Renewal

Name *

First

Last

Credentials *

e.g. MD, NP, PA, RN, etc.

Degree *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Individual Membership *

Physician - $ 100.00
NP/PA - $ 50.00
Affiliate - $ 50.00
Fellows/Residents/Students are free - $ 0.00

Physician Membership ($100): Any physician licensed in North or South Carolina whose professional medical services are provided in part within post-acute or long-term care facilities in North or South Carolina. Eligible to vote, to be elected to the Board, and to hold office.

NP or PA ($50): Any advanced practitioner (NP, PA) licensed in North or South Carolina whose professional medical services are provided in part within post-acute or long-term care facilities in North or South Carolina. Eligible to vote and to be elected to the Board.

Affiliate ($50): This would include the IDT (Interdisciplinary Team i.e. Administrators, therapists, pharmacists, DON, RN) and LIPs (Licensed Independent Practitioners i.e. DDS, CNS, DPM) and Industry. Affiliate members may attend and speak at membership meetings but are not be eligible to vote or hold office.

Student (free): Fellows, Residents, Post Graduate or Undergraduate Medical, Nursing or Other Healthcare Programs. Student members may attend and speak at membership meetings but are not be eligible to vote or hold office.

I am interested in working on the committee(s) as created by the Board such as Education, Membership, Newsletter, and Public Policy.

Total

$ 0.00

Payment Method: *

PayPal
Check to CPALTC

Please select which payment method you will use for your membership dues. If you are paying online, you must complete the payment information, which will be presented on the next screen after you submit this membership application data form.