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 PACE Membership Application
(PACE = Patient Advocate Career Exploration) 
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Not quite ready to fill this out?
Learn more about PACE memberships.

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All fields are required.

• Do you live outside the US or Canada?  Please fill out our PACE International application instead. 
 
 
Name:
Your email address:
Your email address (repeat):
Choose a Login ID for your membership homepage
(minimum 8 characters - please do NOT use special characters like #$%&* or @):

*Important! 
Write down this ID. You wil need it to log in once your membership has been processed and accepted.
Choose a password for your membership homepage
(minimum 8 characters - please do NOT use special characters like #$%&* or @):

*Important! 
Write down this password. You wil need it to log in once your membership has been processed and accepted.
Your city:
Your state/province:
Your country:*
Where are you in your patient advocate career development?
(choose as many as apply)
I am just beginning to think about becoming a patient advocate.
I am taking classes or workshops to become a patient advocate.
  If so, please tell us where you are taking classes:
I have worked as an advocate or caregiver as a volunteer (for a loved one, neighbor, friend.)
I have done some paid work as a patient advocate but am not ready to commit to changing careers to advocacy just yet.
Other (250 characters maximum):
Do you have education or experience working in healthcare?
NO previous work in healthcare
YES (Please describe):
What do you hope to learn during your PACE membership in the Alliance?
How did you hear about the Alliance?
Once you hit SUBMIT, you will be taken to a page with dues payment options. Once you have paid your dues ($59 for year one, or, if you are applying for PACE International*, $29 USD, we will process your membership within 24 hours (sometimes within minutes!) 

You will not be able to log in until your application has been processed
.
As soon as we have your application processed, you will receive a Welcome Email with log in instructions and a link to our PACE Member Orientation.
This helps us reduce spam:




 

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