2010 Membership Application

Dues from January 1- December 31, 2010 are $75.00
Memberships are individual memberships and not transferable

Promoting professionalism, ethical values and excellence in Case Management
through education, networking, and support for the individual Case Manager.

First Name:     Middle Initial:

Last Name:      Credentials:   

Home Address:

City:   State:     Zip Code:

Home/Cell Number (required):

Work Phone Number (optional):

Home Email Address (required):

Work Email Address (optional):

Employer:

Job Title:

Membership Classification (please check one):

Case Manager: a licensed health care professional who provides case management services; is engaged in a collaborative process to access, plan, implement, coordinate, monitor or provide options and services to meet an individuals needs through communication and available resources and to promote a favorable outcome.

Associate Member: An associate member is defined as an Individual, company, or corporation that does not provide direct case management services but does provide the services and products to the Case Manager so that the Case Manager may perform their duties.

Don't forget to mail your membership dues to:
Case Management Society of South Texas
P.O. Box 40456
San Antonio, TX 78229