Application & Forms

Join PRIM&R or renew your membership online

Membership Application and Forms

You may join PRIM&R or renew your membership online. You may also join PRIM&R or renew your membership using the applications and forms below. If you don’t see the form you are looking for in this list, please contact us to request it.

Note: Forms marked with the are accessible only to members who are logged in to the site.

Cancellation Policy: Please note all membership purchases are final and refunds will not be issued for PRIM&R membership dues. However, memberships are fully transferable. In the event that an individual leaves an institution, changes, positions, or no longer needs use of their PRIM&R membership, the remaining months of their membership can be transferred to a colleague free of charge using the membership transfer form above.

Most Commonly Used and Requested Forms

Membership Application

Download and submit this form to join PRIM&R for the first time. You can also join online!

Membership Justification Toolkit

Demonstrate the value of PRIM&R membership to your supervisor and institution.

Membership Renewal Form

Use this form to renew your current or expired PRIM&R membership. You can also renew online!

Membership Transfer Form

Complete and return this form to transfer an existing PRIM&R membership to a different person.

Mentoring Program Form​​​​

Complete this members-only online form to join PRIM&R’s Mentoring Program as a mentor, mentee, or both.

PRIM&R Regional Connections Toolkit and Application

Plan an educational or networking event for your region using these resources.