AMERICAN ACADEMY OF Office Use Only

ANTI-AGING MEDICINE (A4M)

Membership #

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New Membership / Renewal Application Form Acc Rep:____________

Name :........................................................................................................................................................................................................................................

Degrees : MD [ ] DO [ ] MBBS [ ] DC [ ] DDS [ ] ND [ ] PhD [ ] RPh [ ] RN [ ] NP [ ] PA [ ] Other :...............................

Title :....................................................................................................................................................................................................................................................

Practice/Company :....................................................................................................................................................................................................................................................

Mailing Address :....................................................................................................................................................................................................................................................

City, State, Zip :....................................................................................................................................................................................................................................................

Country :....................................................................................................................................................................................................................................................

Phone :...................................................................................................... Fax :......................................................................................................

Email :...................................................................................................... Website :......................................................................................................

MEMBERSHIP CATEGORY
M e m b e r s h i p C a te g o r y 1 Yea r 2 Yea rs 5 Yea rs
[ ] Physician Membership (MD, DO, MBBS) $250.00 $500.00
[ ] Scientific/Healthcare (DC, DDS, ND, DPM, R.Ph, PhD, RN, NP, PA $250.00 $500.00

[ ] Preferred General Public $95.00 - -

I wish to be accepted as a member of the American Academy of Anti-Aging Medicine and agree to abide by its By Laws and Code of Ethics:

Signed :......................................................................................................................................................... Date :..................................................................

Please Select a Voluntary Contribution Level (optional) [ ] US$50 [ ] US$100 [ ] US$150 [ ] ...............................................(Other)

Payment in the amount of US $ .......................................................................... is enclosed (membership dues + contribution)

PAYMENT INFORMATION
Your membership will not be processed without full payment or if your credit card is declined.

[ ] Check # :............................................................... payable to A4M, 1510 West Montana Street, Chicago, Illinois 60614, USA

[ ] Credit Card [ ] MC [ ] Visa [ ] AMEX Name on CC :...............................................................................................................

C C# :.......................................................................................................... Security # :.............................. Expiry:.....................................

Signature :................................................................................................................................... Date :.............................................................

REMIT COMPLETED FORM TO: An Organizational Membership affords you extended benefits.
Contact the A4M Membership Department for details.
_________________________ Allow 6-8 weeks for processing your new membership application
and receipt of your Welcoming Kit and Member Certificate.
Academy of Anti-Aging Medicine Applicants wishing to return their A4M membership are required to
1510 West Montana Street comply to A4M.s
Chicago, IL 60614 USA
Membership Return Policy. Instructions are available on the
Phone:1-800-558-1267 ext 531
Membership. page at www.worldhealth.net and from the A4M
Fax: 561-997-0287
Attn: Membership Department Membership department.
For inquiries, contact Customer Services at: 773-528-1000 or e-mail
Tracking Group# : _____________________ membership@worldhealth.net
A4M Membership

Accomplishments
The A4M's leadership position in the science of anti-aging medicine continues unsurpassed, and our accomplishments over
the past year include:
• A4M's membership stands at 11,500 members from 90 countries, making the A4M both the premier medical society
confronting the dilemmas of aging and the fastest-growing medical society in the world.
• Seminars and physician training programs in venues in Japan, Spain, Singapore, Mexico, Brazil, and Belgium, as
well as New York City, Chicago, and Las Vegas have drawn participants from the most prestigious educational,
government, and private institutions from across the world.
• Board Certification in Anti-Aging Medicine: The American Board of Anti-Aging and Regenerative Medicine
(ABAARM) was created to facilitate the recognition of this emerging medical specialty. To date, there are 400 MDs
and DOs who are Board Certified or Diplomates. The American Board of Anti-Aging Health Practitioners (ABAAHP)
enables Doctors of Chiropractic (DC), Doctors of Dentistry (DDS), Naturopathic Doctors (ND), Doctors of Podiatric
Medicine (DPM), Registered Pharmacists (RPh), as well as scientists, to pursue certification. Since its first
administration in December 1999, over 100 health practitioners have achieved Diplomate status.
• Publications:
o New Anti-Aging Secrets for Maximum Lifespan, with easy-to-use informative self-tests, checklists, and quizzes
sprinkled throughout and powerhouse Plans for Longevity
o Anti-Aging Medical News, a quarterly newsletter reaching 50,000 international readers
o Fifth textbook on anti-aging medicine, Anti-Aging Medical Therapeutics, vol 10
• Distribution of research grants to Dr. Walter Pierpoli (Italy) and Oklahoma State University to support studies that
advance anti-aging medicine
• Expansion of the Internet's #1 anti-aging portal, www.worldhealth.net:
o Supporting A4M's mission of promoting grass-roots advocacy and awareness of this new clinical science to
expand the potential patient base
o Now approaching upwards of 2 million visitors monthly
o On-line Physician's Referral Network, accommodating 350+ patient inquiries weekly
o Features weekly thought-provoking polls, longevity news, audio clips, and late-breaking announcements
from the A4M
• Through mailings and media exposure, the A4M continues its consumer education campaign, introducing millions of
people to anti-aging medicine and related scientific breakthroughs.

Applicants, please note:

• An Organizational Membership affords you extended benefits. Contact the A4M Membership Department for details.
• Allow 6-8 weeks for processing of your new membership application and receipt of your Welcoming Kit and
Member Certificate.
• If the applicant wishes to return their A4M membership, s/he is required to comply to A4M's Membership Return Policy.
Instructions are available at the "Membership" page at www.worldhealth.net and from the A4M Membership Dept.

For inquiries, contact A4M Membership Department, Tel: (800) 558-1267, Fax (561) 997-0287,
or e-mail member@worldhealth.net.
 A4M Membership

What is the A4M Membership?

As an all-volunteer medical society, the officers and directors of A4M receive no financial compensation for their tireless
efforts in developing and promoting the organization. Yet, the A4M remains committed to expanding the benefits of your
membership. As of November 2008, we are pleased to announce member benefits that put your membership dollars to work
for you as well as the burgeoning clinical specialty of anti-aging medicine.

Member Benefits
Becoming a member of A4M gains you access to over a decade of established anti-aging expertise. Position yourself as being
the first to learn of the latest breakthroughs in preventive and interventive techniques that help your patients achieve their
personal best in wellness, maximum longevity and a fulfilling quality of life.

Join now, increase your practice income and take advantage of the following membership benefits:
• A4M Accreditation: A4M maintains the most recognized credentialing program for physicians, scientist, and
healthcare professionals.
• Physician Generation Service: A4M fields approximately 350+ inquires monthly from the public, interested in
finding a qualified anti-aging medical specialist, groups and other services.
• Anti-Aging Physicians and Health Practitioners Directory: Over 700 listings of physicians, searchable by name
and location
• Anti-Aging Clinics and Spas Directory
• Anti-Aging Products and Services Directory
• American Board Certification Programs: A4M membership makes you eligible to take the written and oral exam to
become board certified. ABAARM offers medical professionals recognition of specialty knowledge and clinical
practice of anti-aging medical care.
o The American Board of Anti-Aging and Regenerative Medicine (ABAARM) -
For PHYSICIAN MEMBERS ONLY - issues Board Certification to individuals with M.D. (Doctor of Medicine),
D.O. (Doctor of Osteopathic Medicine), and M.B.B.S. (Bachelor of Medicine/Bachelor of Science) degrees.
o The American Board of Anti-Aging Health Practitioners (ABAAHP) - For SCIENTIFIC HEALTHCARE
MEMBERS ONLY - issues Diplomate Certificate to Doctors of Chiropractic (DC), Doctors of Dentistry (DDS),
Naturopathic Doctors (ND), Doctors of Podiatric Medicine (DPM), Registered Pharmacists (RPh), scientists
(PhD and similar), Registered Nurses, Nurse Practitioners, and Physician Assistants.
• Advertising Opportunities: Receive special discounts on print advertising, online advertising and conference booths
and reach out to your prospective customers.
• Complimentary subscription to our award-winning journal: Anti-Aging Medical News: Anti-Aging Medical News:
This trendsetting industry publication serves as a forum of exchange between physicians and professionals delivering
clinical healthcare, scientists, researchers, government and private institutions and commercial entities.
• Discounts on all A4M-sponsored events: As members, you will receive special incentive DISCOUNTS (up to nearly
50% discounts on the actual on-site value of the registration).
• Discounts on A4M Educational Materials: Learn anti-aging from the organization that created the anti-aging specialty
with our library of. State-of-the-Science educational books, videos, tapes, and CDROMs.
• Complimentary Electronic Biotech Newsletters: E-Biotech Newsletter (EBN) is a service of the American Academy
of Anti-Aging Medicine, focused on clinical answers to aging related disorders leading to a longer and
healthier lifespan.
• Exclusive Promotional Offers: Receive promotional offers/samples from hundreds of vendors before each
medical conference
• Discussion Forum
• Networking Opportunities
• Financial Incentives: Many members can save more than the actual cost of their annual membership dues through all
of our financial incentives.
• Discounts on Professional Marketing Materials
• Complimentary subscription to A4M News
 Directory Listing

Get Listed
The anti-aging directory is one of the most popular areas of our website. Our visitors are keen to learn about and experience
the anti-aging lifestyle and practices they read about when visiting. A listing on our directory will put your practice, product
or spa in front of an audience keen to live a healthy, anti-aging lifestyle living in your local area.

Examples of Listings
Premium listing positioning and advantages
With a Premium listing you can enjoy the following benefits in addition to those received with a Full listing:
• Listing in the top section of research results. The listings will rotate daily so all entries can enjoy the same exposure
• A bold and prominently highlighted listing
• Improve the look of your listing and build your brand with an image or logo
• Provide your potential customers with vital information about your product or service whist their interest is fresh

Full listing positioning and benefits

With a Full listing you will receive the following benefits in addition to those received with a basic* listing:
• Feature above the basic* listings in search results. The listings will rotate daily so all entries can enjoy
the same exposure
• A bold and highlighted listing
• A direct link to your website
• Receive enquiries from potential customers direct to your inbox with our contact form

* Basic listings are not available to purchase. They are only made available by A4M as part of selected promotions
or packages.