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ACLP Non-Member SIG application

Use this form if you are NOT a member of the Academy of Consultation-Liaison Psychiatry.

Academy members: Edit your SIG subscriptions via your membership profile: https://members.clpsychiatry.org/account/profile.aspx
1. Your contact details *This question is required.
2. Mailing address *This question is required.
3. Which ACLP SIG are you applying to join? You may select more than one. *This question is required.
5. Please indicate the type of clinician you are *This question is required.
6. How long have you been interested in HIV/AIDS Psychiatry?
6. Are you involved in research or do you have a research interest? *This question is required.
6. Please indicate which of the following transplanted organs you are involved with (you may select more than one) *This question is required.