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Become a Member

Heartland Rural Physician Alliance invites independent and independent-minded physicians, clinic and hospital administrators, and other patient care providers to join our organization. 


Annual membership fee per individual 

Physician: $500     Healthcare Administrator: $250
Non-physician Healthcare Provider (PA, NP, ARNP, etc.): $250


A completed form must be submitted for each provider applying for membership.

Membership Application Type
Must select one option below.

Applicant Contact Information


Practice Information


Office or Practice Administrative Support Contact

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