New Physician Member Sign Up

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EIN membership is a benefit of IDSA or PIDS membership; no additional dues are required.

EIN Membership Requirements
You must:

1. be an infectious diseases physician
2. see patients on a regular basis
3. be willing to complete periodic brief surveys
4. be an IDSA or PIDS member

If you have questions about the EIN, you may contact the Program Coordinator, Susan Beekmann, RN, MPH at ein@uiowa.edu.

Please complete the form below to join the EIN. The Program Coordinator will contact you shortly with membership materials.

First Name
Middle Initial
Last Name
Degrees
ID Training Status	Finished training Currently in training
Year Finished ID Training Enter expected year if currently in training
Hospital Type	University Non-University Teaching City/County Hospital Community Hospital VA/DOD Hospital Other
Institution/Practice Name*
Patients Seen	Adults Peds
Work Address Line 1*
Work Address Line 2
City*
State*
ZIP*
Country
Email*
Comments

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