NSCHBC Membership Application

Please complete all sections of this form to submit your application for membership with NSCHBC. Items with an asterisk (*) are required fields.

Section 1 - Contact Info

 

Section 2 - Business Practices A

  • (Response required for all 5 areas)
 

Section 3 - Business Practices B

 

Section 4 - Business Practices C

  • (either as a third party advisor or employee of a healthcare organization):
 

Section 5 - Acknowledgement

  • I have reviewed the NSCHBC's code of ethics prior to completion of this application. It is expressly agreed that should I terminate (or be terminated) from membership in the National Society of Certified Healthcare Business Consultants for any reason, use of the NSCHBC logo and other identifying data will be discontinued immediately. I understand that a non-refundable application fee of $125.00 must be included with my completed application. I understand that in order to be accepted as a member in the National Society of Certified Healthcare Business Consultants, my application must be reviewed by Membership Committee. I understand that new members must attend an educational meeting within three years of joining NSCHBC. I represent that the foregoing responses are factual at the time of this application and that they are presented on a basis for the consideration of my membership application.
 

Section 6 - Payment

  • By clicking the "Submit Application" button you will be taken to the billing form to fill out your credit card information. Please note that all fees and dues are non-refundable.
 

Verification