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  • Rhode Island Society of Acupuncture and Oriental Medicine

    Welcome to RISAOM!

    Rhode Island Society of
    Acupuncture and Oriental Medicine

Rhode Island Society

of Acupuncture & Oriental Medicine


Membership Application/Renewal and Contribution Form

The Rhode Island Society of Acupuncture and Oriental Medicine (RISAOM) is a non-profit, professional organization. Its purpose is to promote the practice of acupuncture and Oriental medicine as an effective and valuable component of our health care system and to establish excellence in the professional and ethical standards of its members. Please join this commitment to strengthen our profession.
Name _____________________________________________
Address ___________________________________________
___________________________________________
Home phone ________________ Work phone _____________
Fax ______________________ E-mail ___________________
____ Professional ($150) RI Acupuncture License # ___________
____ Student ($25)
____ Allied Health Professional ($75)
____ Friend/Associate ($35)
____ Contribution: Amount $ ____________
Enclosed is my check for $ ____________
Please make your check payable to the Rhode Island Society of Acupuncture and Oriental Medicine (or RISAOM) and send it to:

Rhode Island Society of Acupuncture and Oriental Medicine Treasurer
PO Box 6681 Providence, RI 02940