LEE COUNTY MEDICAL SOCIETY, INC.
MEMBERSHIP APPLICATION AND INFORMATION
13770 Plantation Road, Suite 1
Fort Myers, FL, 33912
Above is a link for a Lee County Medical Society application. Please complete and return to the Medical Society office for processing.
Please be sure when filling out your application that you include all addresses of your practice in Lee County and not your present address outside of Lee County. Addresses must be complete for physician references, association references, medical schools, internships, residencies and other hospital affiliations. Zip codes are needed. By including the above you will speed up the application process.
We will need a professional photo taken within the past year. The photo will be used for the LCMS Pictorial Directory, Bulletin, and website. You may mail a photo with your application or email a 250px x 315px, 300dpi resolution file (jpg, png or tif) to the Lee County Medical Society Office.
Once your application has been received your references will be checked. Please allow enough time by sending us your application as soon as possible. Please use only references of your peers (M.D.'s or D.O.'s). Do not use relatives, non-physicians or references in Lee County*. The Society reserves the right to contact anyone who might have an opinion concerning your qualifications. In addition to your application and three photographs, a copy of your Florida Medical License is required. Your continuing Medical Education number from the American Medical Association is required for dues processing. If you do not have this number leave it blank and we will contact the AMA. After favorable action by the Committee on Ethical and Judicial Affairs (EJA) and Board of Governors, your application will be presented to the Membership for their final approval. It is important that you or your office make appointments to interview with two members of the Committee on Ethical and Judicial Affairs (In person or over the phone).
Should you have any questions, please contact the Medical Society office. We will be glad to assist you.
- Ann Wilke, Executive Director Lee County Medical Society, Inc.
Telephone (239) 936-1645
*EXCEPTION: A physician practicing in the Lee County area for MORE THAN FIVE YEARS does not have to provide out of town references, but may use four medical references from the Lee County area or outside of Lee County. Two references in Lee County must be Lee County Medical Society members and no more than two references can come from the applicant's immediate practice.