Request a New Special Interest Group (SIG)

If you are interested in forming a special interest group of a particular clinical, scientific, or educational area as it relates to psychosomatic medicine and which you think would be beneficial to the APM membership, please first review the APM Policy on SIGs, and then fill out and submit the form below.

Your Name:

Your email address:

Re-enter your email:

Your telephone:

Suggested name of new interest group:

Description, purpose, benefits of the new interest group:

Academy resources your group will want:

Listserv
Web page
Meeting time at the annual meeting
Other staff support (please describe):

Ten APM members are required to be founding members of the new group. List the ten members who are committed to the new SIG below. Each of these members must fill out and submit a Statement of SIG Support. (If there are less than ten committed APM members, enter N/A for each missing member and see the note below.)

10.

NOTE: If you have less than ten committed APM members, explain here:

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