Return completed form to: infopasg 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the designated field. Ensure that you print or type all responses clearly.
3. Fill in your office address as your preferred mailing address, followed by your home address in the next section.
4. Provide your best contact number and email address. Remember to grant permission for PSG to add your email to their database.
5. Complete the sections regarding your medical school, residency, GI fellowship, and medical license number accurately.
6. Indicate your board certification status and select your membership type while ensuring you understand the dues associated with each option.
7. Finally, choose a payment method for the membership dues and fill in the required credit card information if applicable.

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