Become a Member – SCACVPR

The South Carolina Association of Cardiovascular and Pulmonary Rehabilitation (SCACVPR) is dedicated to enriching the professional careers of it members.

Complete the form below to submit your application online. You will be re-directed to PayPal at the end to pay your dues. You must pay dues to be considered a member of SCACVPR.

Name of Program/Individual Filling Form

Name:

Last

First

Middle

Program:

E-mail:

Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

Phone:

Area Code

Phone Number

Affiliation:

Institution

City

1/4

Complete This Section For Program Memberhip Only

Occupation:

Major:

Educational Degree:

2/4

Complete This Section For Individual Memberhip Only

Medical Director:

Director:

Exercise Specialist:

Nurse/Educator:

Dietitian:

Vocational Counselor:

Psychologist:

Office Management:

Secretary:

Other:

Date Program Established:

Date Fully Certified

Average # New Patients/Month:

# of Participants

Location of Sessions:

Cost Of:

Days/Time Program Meets:

Exercise Sessions:

Psychological Assessment:

Follow-Up Cost

Dietary Assessment:

Follow-Up Cost

Exercise Test:

Body Composition Cost

Pulmonary Function:

Blood Lipid Analysis Cost

Attending Physician/Session:

Other Costs:

3/4

Payment

Dues:*

Annual Membership

Total:

4/4

Promote high standards in cardiac and pulmonary rehabilitation.
Receive professional education through educational conferences.
Network with professional peers to enhance knowledge and understanding.
Act as a unified voice on legislation and issues that affect the quality of cardiopulmonary rehabilitation.
Have fun.

To become a member you can either download and fill out our application and mail it in with your dues, or fill out the online application to the left.

Membership runs from May through April of each year. Membership dues: $225.00

Name of Program/Individual Filling Form

Complete This Section For Program Memberhip Only

Complete This Section For Individual Memberhip Only

Cost Of:

Payment

Join us today to:

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