Thank you for your interest in becoming a Consulting Physician with linkUSAdoctor.com. We help you utilize the power of the Internet to expand your practice, without the worry of having to learn how to build a web page. Physicians who have at least 10 years of experience after their residency and have an established background in their specialty fields are eligible to give consultations.

For USA Health Care Providers:
If you would like to join our membership, please fill out this initial application form with your personal information and when you reach the end of the form click on Continue and proceed to fill out your Physician Office Information and Medical Educational Background. If you would like to, you can also email your resume to us. The application charge of US$99 is currently being waived so we can show you the benefits linkUSAdoctor.com has to offer.

We reserve the right to choose physicians without giving explanations for any applications that have been rejected.


New Doctor Registration

Please fill out the following form:

Title:   Mr.   Mrs.   Ms.   Dr.
First Name:     MI: 
Last Name:  
Address:  
 
City:  
State/Province:  
Zip/Postal Code:  
Country:  
E-mail:  
Home Phone:  
Work Phone:  
Fax:  
Date of Birth:   (MM/DD/YYYY)
Sex:   Male     Female

 Yes, I would like to receive periodic E-mail newsletters with health and fitness tips from our leading physicians.

Please choose a Login Name and Password that you will use for future visits to linkUSAdoctor.com:

Login Name:  
Password: