Check one:

Current Member

New Member - You will be billed for your new membership. See the New Member Special page in this packet.

Practitioners Name  

Practice, Clinic Name
or Physicians 

Business Address  

Business Billing Address  

Office Phone Number  

Emergency/ After Hours Phone Number  

Business Fax Number  

Business E-Mail Address  
(public only by request)

Office Manager’s Name    

Driving or Location Instructions    

Practice Type to be listed as 
(i.e., oncology, family practice, pediatrics etc.)

Illnesses/problem solving subjects  practitioner should be associated to:  

Keywords that are associated with your practice 
(used for locating your practice by individuals searching for your specialties

Level of Presentation

 Basic Line Listing – Complements of La Plata Medical Society – No Charge  

Line Listing with Link to existing web site  

Display Ad  

Premier Member Solution

Note: All work and training (if applicable,) will be completed to your satisfaction. When you are satisfied with your presentation, we will bill you with an acceptance of completion form.  
If you opt for the Premier Member Solution – technical support is available for your presentation.  
We have a highly trained technical staff that will be available to you 9-5 M-F in the event of technical problems you may encounter. Fees may be applied for these services based on the nature of the problem.

E-TECH

Durango, Co. 81302

If you have any questions, please call Elliot Albo at 970-749-3001 or e-mail Elliot at Elliot@laplatamedicalsociety.com. 

For further reference contact Christopher Roach at 970-382-8800 M-F.