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Thank you for your interest in the Kentucky Primary Care Association. 

KPCA has three categories of membership: Licensed, Organizational and Individual. Please follow the link to the form 
pertaining to your membership type. When we receive your submission, we will contact you.

The dues structure follows.

TYPE VARIABLES ANNUAL FEE
Licensed Less than $500k in operating expenses $500
  $500,001 to $2m in operating expenses $750
  $2,000,001 and more in operating expenses $1,000
 
Organizational 0 to 25 employees $200
  26 o 50 employees $320
  Over 50 employees $480
 
Individual   $20

Licensed Membership

Licensed Primary Care Center

Licensed Rural Health Clinic

Licensed 330 Grantee

Other: Please specify

To determine your annual membership dues, please indicate the appropriate category of operating expenses for your organization.

Comments:

Please provide the following contact information:

Name
Title
Organization
Mailing Address
Street Address
City and State
Zip
Work Phone
FAX
E-mail
URL

Organizational Membership

To determine your annual membership dues, please indicate the number of employees:

Comments:

Please provide the following contact information:

Name
Title
Organization
Mailing Address
Street Address
City and State
Zip
Work Phone
FAX
E-mail
URL

Indivdual Membership

Annual membership dues for individuals are $20.00.

Comments:

Please provide the following contact information:

Name
Title
Organization
Mailing Address
Street Address
City and State
Zip
Work Phone
FAX
E-mail
URL
Copyright © 2004 Kentucky Primary Care Association, Inc. All rights reserved.
Revised: June 09, 2008