Manage Profile   |   Print Page   |   Contact Us   |   Your Cart   |   Sign In   |   Register
SDPA State Affiliation Form Application
Share |

An SDPA affiliate chapter is an independent state affiliate dermatology PA organization. Affiliate chapters provide valuable information and insight about the dermatology specialty in their state and to SDPA membership and leadership. Affiliate chapters are not chartered, although they remain an integral part of the SDPA framework and ensure the Society has the maximum amount of knowledge and understanding of issues effecting dermatology PAs in each state. Most importantly, our affiliate chapters strengthen the PA profession through their liaisons with their medical and professional counterparts in each respective state. These relationships allow affiliate chapters to partner with the SDPA to effectively address challenges such as reimbursement, clinical practice, and regulation.

Before filling out the application below, make sure you meet all the requirements and have the necessary information on hand.

State Affiliate Approval Checklist for SDPA

  • State Affiliate information
  • Name of State Affiliate
  • Date founded
  • Copy of bylaws - necessary to be considered for SDPA recognition
  • Copy of articles of incorporation - not required to be considered for state affiliate recognition, however, highly encouraged
  • State Affiliate elected officers - minimum of 5, include names, addresses, titles, terms in office
  • SDPA requirement of Fellow members
  • How many members
  • Goals and purposes of State Affiliate
  • Activities of the State Affiliate organization since organizing
  • Activities the State Affiliate has planned for the future
  • Why the State Affiliate organization is applying for recognition
  • Contact Information of Submitter
    • First and Last name
    • Position in organization
    • Street address
    • City
    • Zip code
    • Organization phone number
    • Email
  • Name of person agreeing to comply with the SDPA's mission and objectives with date of agreement

State Affiliation Form Application

State Affiliate Information
Bylaws & Organizational Documents

To be considered for SDPA recognition, bylaws are required. If your organization has been incorporated, please attach a copy of your articles of incorporation. Incorporation is NOT required to considered for state affiliate recognition; under specific circumstances, it is highly encouraged. For more information on the benefits of incorporation contact SDPA Constituent Relations Committee Chair Sara Wilchowski at swilchowski@dermpa.org. You can also view sample templates of these documents here.

Leadership Information
List the state affiliate elected officers. Minimum of 5 and include names, addresses, titles in organization and terms in office.




Additional Information





Agreement

The State Affiliate organization understands that to maintain continued recognition with all privileges, the State Affiliate organization's actions must not conflict with SDPA's mission or objectives and the following must be adhered to: 

  • Agreement to be signed
  • Communication with co-chair at least 4 times/year
  • Respond to emails from the SDPA within a reasonable amount of time (i.e. 7 days)
  • Mandatory meeting at the SDPA conferences to be lead by one of the affiliate's board members
  • All updates, such as contact info, to be provided to the SDPA immediately


 The SDPA's Mission and Objectives:

The Mission of the SDPA is:

Advancing the care of patients through the education and empowerment of Dermatology PAs.

The Objectives of the SDPA Are To:

  1. Empower - Form a leadership structure that provides for communications, collegial
    relationships, and member advocacy.

  2. Educate - Provide continuing medical education that enhances the skills, knowledge, and roles of PAs in the practice of dermatology.

  3. Advance - Advance the utilization of PAs in the team practice of medicine with dermatologists.

Calendar

SDPA 15th Annual Fall Dermatology Conference 2017 - Cancelled
November 8-11, 2017 – Caribe Hilton – San Juan, Puerto Rico

SDPA Annual Summer Dermatology Conference 2018
June 28-July 1, 2018 – Westin Hotel – Seattle, WA

Membership Management Software Powered by YourMembership  ::  Legal