Membership Application | TACVPR - Texas Association of Cardiovascular and Pulmonary Rehabilitation

For information about our member recruitment program click here.

The TACVPR membership year runs January 1st – December 31st.

Please complete the following:

Name
FirstLast
Nickname
Company / Facility Name
Name of Program
Title
Discipline (RN, EP, etc)
Work Information
Work Address
Work City
Work State
Work Zip Code
Work Phone
Work Fax
Home Information
Home Address
Home City
Home State
Home Zip Code
Home Phone
Home Fax
Email
- Member of AACVPR
RAP (Refer-A-Pal) Program
Were you referred to us by another member? If so, whom:
Program Information:
Program Manager
Contact Phone
Email
Check all that Apply (Cardiovascular Rehabilitation):
- Inpatient
- Outpatient
- Hospital Based
- Free Standing
Check all that Apply (Pulmonary Rehabilitation):
- Inpatient
- Outpatient
- Hospital Based
- Free Standing
Please fill out either "Professional Member" or "Student Member" below:
Professional Member ($45/year | $35 on or before 2/14)
Physician, Medical Scientist, Allied Health Professional, Educator, and/or Nurse involved in some aspect of cardiovascular and/or pulmonary rehab.
Degree(s)
Principle field of education
Certification(s)/License(s)
Section Break
Student Member ($10/year)
Undergraduate or graduate student currently enrolled in a medical or allied health curriculum with a minimum of 6 hours interested in cardiovascular and/or pulmonary rehabilitation. No voting priveleges granted. Must mail or fax a copy of your student ID to TACVPR.
Institution
Major
Anticipated Graduation Date

Next, you will choose either “Professional Member” or “Student Member” to pay your dues.

Work Information