: NSMS

Membership Application for Residents

Please enter the information requested below to apply for Napa Solano Medical Society membership as a resident. All fields marked * are required.

Directory Information

Certain fields, like your first and last name fields, are disabled for existing accounts to preserve critical information and avoid confusion. To change the information in these fields, applicants should reach out to their county medical society for assistance.

CA Medical License #

CA License Expiration Date

Prefix

First Name

Middle Name

Last Name

Suffix

Primary Degree

Other Degree(s)

To select multiple degrees press and hold the Ctrl or command key.

In addition to your program email, we encourage you to list your personal email in the Alternate Contact Information section to ensure there are no disruptions in our communications with you.

Email Address

Username

Password

Confirm Password

Personal Information

Date of Birth

Gender

Ethnicity