MAMA Membership Application

    Address

    Primary Contact
    (This individual will serve as the main representative for your company, ensuring that MAMA information is passed on to the appropriate person(s) and keeping MAMA apprised of any address and staff changes within your organization.)

    Secondary Contact (if any)

    Membership Type Descriptions

    Regular Membership - Available only to individual or business entity providing medical alert or telehealth systems to customers and/or providing monitoring services for such systems.

    Associate Membership - Available to any individual or business entity which does not otherwise qualify as a Regular Member but which markets systems, equipment or other services to Regular Members.

        *NOTE: If applying for Regular Membership, dues are based on your company‚Äôs annual gross revenue, which is self-reported and based on the honor system. An individual company's dues level will be kept confidential. MAMA reserves the right to review dues levels for accuracy and make adjustments as necessary.