Membership Application

Membership Category

(a) Receipt of a MD or DO degree at least five years before membership; (b) The applicant shall be eligible for the American Board of Urology or the American Board of Osteopathic Surgery and provide proof as same; (c) Letters of recommendation from two members of the Florida Urological Society; If the applicant is a member in good standing in the American Urological Association (AUA) and the Southeastern Section of the AUA, Inc. (SESAUA), letters of endorsement will be waived. (d) Attendance at an annual meeting within two years following the filing of his/her application and; (e) Limit his/her practice to teaching or clinical practice of urology.
(a) Physicians residing in the State of Florida who limit their practice or have a special interest in Urology, may be nominated for Associate Membership; (b) Application for Associate Membership must be recommended by the Membership Committee and endorsed by the Executive Committee; (c) May apply for active membership when they fulfill the requirements.
A practicing Urologist in the State of Florida who has (a) completed residency within the last three calendar years and (b) receipt of a MD or DO degree at least 5 years before membership.
NP/PA and Administrators membership is available to practice mangers, physician assistants and nurse practitioners specializing in urology and not otherwise eligible for membership in the FUS. Application and renewal of membership requires sponsorship by an active or senior member of the FUS. NP/PA and Administrators members shall have all the privileges of active membership, but cannot hold office or vote.
A resident currently in training in the Urological field in Florida will be elected upon completion of an application and receipt of recommendation from the Chief of the residency program.

Applicant Information

Applicant Addresses

Office Address

Home Address

Applicant Credentials

  • College

  • Post Graduate

  • Medical School

  • Residency

  • Fellowship

Check the Following

  • Diplomate American Board
  • Eligible to take examination of American Board of Urology
  • Have applied to take American Board of Urology
  • Member, American Urological Association
  • Member, Florida Medical Association
  • Have you ever received an official censure or reprimand from a medical society?
  • Are you now or have you ever been party to malpractice litigation?

Letters of Recommendation

Active and Associate applicants ONLY
Give names and addresses of two members of the Florida Urological Society as references and ask them to write letters of recommendation for you.

Please send the letters of recommendation:

  • Via Mail:
    Membership Department
    Florida Urological Society
    1100 E. Woodfield Road, Suite 350
    Schaumburg, IL 60173

Payment Information (must be made in U.S. dollars)

  • Billing Information

If paying by check, make check payable to: Florida Urological Society

Mail payment to:
Florida Urological Society
Two Woodfield Lake
1100 E. Woodfield Road, Suite 350
Schaumburg, IL 60173

By submitting this application, you are agreeing to abide by the Constitution and Bylaws of the Florida Urological Society if accepted for membership.
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