Thank you for your interest in becoming a member of the Cooperative of American Physicians, Inc. You may apply online, or complete a fillable PDF application and submit it via fax or mail. (Please use Adobe Reader to complete the application online. Other programs such as Apple Preview will not work.)

If you prefer to fill out the application by hand, please use this PDF application.

If you have any questions during the application process, please contact a Membership Development account executive by calling 800-356-5672 or by clicking the “Speak to a Representative” link to the left.

We look forward to receiving your application!

Returning to Your Saved Application - use this page to return to your saved application. (Press Ctrl + D to bookmark this page.) If you forget your password, use the link on this page.