Physician Application | Minnesota Medical Association

Workplace/Place of Work:

First Name:

Last Name:

Member Status:

Email:

Phone Number:

Phone Type:

Please rank your most preferred committee first, and your least preferred committee third. If there is only one committee that you want to serve on, please note that as an additional note within the "Why are you interested" field.

Ethics and Medical Legal Affairs:

Equity in Access & Quality Committee:

Public Health:

Why are you interested?