Thank you for your interest in membership in the Cooperative of American Physicians, Inc.
You may submit your application using either of the following options: 

Option 1: Online Membership Application (Recommended)

Simply fill out the application online and submit via our secure online form. Once you create your login and password, a record of your application remains available for you to access online at any time.

• Our online application is divided into several numbered steps. You may save your application at any point—as often as you like—and return to complete remaining sections later, using your unique login and password.

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.

• If you have a question about any aspect of the application, one of our account executives will be happy to help you. Support is available by calling our Membership Development Department at 800-252-7706 Monday through Friday between the hours of 9:00 a.m. and 5:30 p.m., Pacific Time. You may also send an e-mail to md@CAPphysicians.com
  

Option 2: Mail or Fax Membership Application 

CAP Membership Application (fillable PDF format)  

The application above may be filled online and then printed. (Please use Adobe Reader to complete the application online. Other applications such as Apple Preview will not work.)

CAP Membership Application (regular PDF format)

To fill out the application by hand, simple print the above form and remit with the supplementary materials indicated therein.

• Fax your application to:
  213-473-8773
• Mail your application to:
  Cooperative of American Physicians, Inc.
  333 S. Hope St. 8th Floor
  Los Angeles, CA 90071
• If you have a question about any aspect of the application, one of our account executives will be happy to help you. Support is available by calling our Membership Development Department at 800-252-7706 Monday through Friday between the hours of 9:00 a.m. and 5:30 p.m., Pacific Time. You may also send an e-mail to md@CAPphysicians.com at any time and we will respond on the next business day.