NEW MEMBER APPLICATION
Thank you for your interest in membership in the Cooperative of American Physicians, Inc.
You may submit your application using either of the following options:
Option 1: Online Membership Application (Recommended)
Simply fill out the application online and submit via our secure online form. Once you create your login and password, a record of your application remains available for you to access online at any time.
- Our online application is divided into several numbered steps. You may save your application at any point—as often as you like—and return to complete remaining sections later, using your unique login and password.
Returning to Your Saved Application - use this page to return to your saved application. (Press Ctrl + D to bookmark this page.) If you forget your password, use the link on this page.
- If you have a question about any aspect of the application, one of our account executives will be happy to help you. Support is available by calling our Membership Development Department at 800-252-7706 Monday through Friday between the hours of 8:30 a.m. and 5:30 p.m., Pacific Time. You may also send an e-mail to memdev@cap-mpt.com
Option 2: Mail or Fax Membership Application
CAP Membership Application (PDF format)
The application above may be viewed onscreen and printed. To fill out by hand and mail or fax back to us, simply print the form and remit with the supplementary materials indicated therein.
- Mail your application to:
Cooperative of American Physicians, Inc.
333 S. Hope St. 8th Floor
Los Angeles, CA 90071 - Fax your application to:
213-473-8773 - If you have a question about any aspect of the application, one of our account exectutives will be happy to help you. Support is available by calling our Membership Development Department at 800-252-7706 Monday through Friday between the hours of 8:30 a.m. and 5:30 p.m., Pacific Time. You may also send an e-mail to memdev@cap-mpt.com at any time and we will respond on the next business day.





