Arizona Urological Society
Membership Application
& Dues Renewal
Please complete this simple form and the payment page.
Your application or renewal will be acknowledged by email. THANK YOU!

Please select one choice below. The annual dues amount may be paid by check or credit card on the next page. *
New Member or Renewal? If renewal, you need only complete the required (*) fields below. *

This section for new member urologists only - skip if not applicable:          
Board Certified?
If no, are you board eligible?
Are you interested in a leadership role?

                                                                                                                                                       
I hereby make application to the Arizona Urological Society and I agree to abide by the Articles of Incorporation and Bylaws.

Click "Continue" button below. On the next page you may pay your fees by credit card or by check.

NOTE: Organization dues may be deductible as professional or business expenses, to the extent allowable by law. Dues and other contributions are not deductible as charitable contributions for federal income purposes.

Questions: Please contact us at 714-550-9155 or via email at dues@desantisgroup.com