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Active Member Application

Membership Criteria: You must be a board certified and / or licensed practicing physician or surgeons of related disciplines.

Submission Criteria:

  • Complete and submit online or download, sign and send to info@isttt.org

  • One signed letter or email of sponsorship from the current ISTTT active board member

  • Current Curriculum Vitae

  • Digital color professional photo

  • Membership Dues: $100 USD

Download Application:

Degree
MD
DO
DPM
MBBS
Other
Gender
Male
Female
Prefer Not To Answer
Race / Ethnicity
Asian
Black / African
Hispanic / Latino
Middle Eastern / North African
White
None Of The Above
Prefer Not To Answer
Practice Type
Solo Practice
Single-Specialty Group
Multi-Specialty Group
Full-Time Employee Of Medical School / University
Other
Office Contact Information
Personal Contact Information
Colleague Contact: ISTTT members can log in to the members-only section of the website to find colleagues’ contact information, including work address, email address, and phone numbers, unless the member has chosen not to share them.
I DO NOT want my email addresses made available to other ISTTT members
I DO NOT want my phone numbers made available to other ISTTT members
Education & Training
Medical or Surgical Specialty
Orthopedic Surgery
Podiatry
Plastic Surgery
Vascular Surgery
Family Medicine
Radiology
Hematology
Infectious Disease
Endocrinology
Diabetology
Internal Medicine
Other
Residency Training
Fellowship Training (If Applicable)
Professional Experience
Are You Involved in Teaching?
Yes
No
Are You Involved in Clinical or Basic Science Research
Yes
No
Sponsorship

A current ISTTT active board member must provide a signed letter or email to info@isttt.org of sponsorship on your behalf

I confirm that the information provided in this application is true and accurate. I understand that by submitting this application, I give ISTTT permission to make inquiries and conduct any investigation it considers necessary to verify my credentials.

Please submit the application and other application material identified in the submission requirement checklist  to info@isttt.org.


Upon receipt of all application requirements, your documents will be reviewed by the ISTTT board and then your name will be presented for final approval to the board of directors. You will be informed of the review progress as it proceeds and notified when our membership has been approved. At that time, your due notice and link for payment
will be sent and your member benefits will begin.

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