• Heart Institute Membership
  • Membership Application

    Please complete the information below and click "submit my application" to apply for CSHI membership.

    Note: The information entered into this form CANNOT be saved and completed at a later time. The form will need to be submitted at the time of data entry.

    If you have questions regarding membership or if you have difficulties submitting this form, please email our membership coordinator: rosalina.kam@cshs.org

    * indicates a required field.

    Demographic Information



    M.D. Ph.D.
    M.D.
    Ph.D.
    D.V.M.
    PharmD.
    Other


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    Membership Type*

    Based on the Membership Policy, please select the type of membership for which you are applying:


    Full Member
    Member-In-Training (Candidate is actively enrolled in CSHI fellowship, housestaff or post-doctoral training programs)

    Documents

    Membership documents are not required if you currently have an active, approved appointment in the Cedars-Sinai Professorship (full-time faculty or the clinical Professoriate) in the areas of cardiovascular medicine or cardiothoracic surgery.

    Please check this box if the above applies to you and you wish to move forward to the next section.

    Please upload a Membership Statement* (maximum 1,500 words) which addresses:

    • your interest in joining the Cedars-Sinai Heart Institute;
    • your fulfillment of membership criteria requirements listed in the Membership Policy
    (maximum file size 6MB)

    Please upload a copy of your full Curriculum Vitae* in Cedars-Sinai standard format. Please highlight in yellow any publications that are related to cardiovascular medicine/surgery.

    Please check this box to indicate that you have already applied to the Cedars-Sinai Professorial Series. We will use the CV that you provided there for your Heart Institute Membership application and you will not be required to upload your CV at this time.

    (maximum file size 6MB)

    If relevant to your application and available, please upload your current NIH biosketch

    (maximum file size 6MB)


    Heart-Related Areas of Interest

    Please indicate up to three areas of heart-related research interest.





    Membership Agreement and Submission*

    Please indicate your agreement with the Membership Policy and your interest in joining the Heart Institute by reading the Membership Agreement and clicking on the submit button below:



    I have read the CSHI Membership Agreement and AGREE to the terms and wish to submit my application to join CSHI.

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    Thank you.


    If you have questions regarding membership or if you have difficulties submitting this form, please email our membership coordinator: rosalina.kam@cshs.org