Credentials* Please include here the Credentials which will follow your name on your Member Page.
Tell us about yourself...* Please describe your practice and your interest in the Refractive Surgery Alliance Society.
Cell Phone*
We require your cell phone in the unlikely event we need to reach you immediately at a Conference, Premier Practice Showcase, Webinar, etc...
Biography (Not your CV)* Members receive a "Member Bio Page" on the Refractive Surgery Alliance website, among other things. Please provide a short biography about yourself to be included on your RSA Member Page upon approval of your application for membership. This will serve as an introduction to web site visitors. Please use "third person" in writing style. (i.e. Mary Jones, MBA, is the Managing Director of World Pharmaceuticals headquartered in Bern Switzerland. Ms. Jones is a graduate of...)
This page provides potential patients with an insight into your personal approach to refractive surgery. It should reflect your passion, your philosophy and your purpose. It should NOT repeat what is published on your practice web page, but should speak directly to patients as if they met you in your office. Sterile content about your professional background is not as compelling as statements about your commitment to helping them achieve their goals in pursuit of better vision.
The following general format may be appropriate – this is your page so make it what you want it to be:
Paragraph 1: Who you are, where you serve, why your practice.
Paragraph 2: What a practice can expect from the professional services you provide.
Paragraph 3: What motivates you to work in the field of healthcare and vision correction services?
Paragraph 4: Credentials/Training/Positions/Accolades/Areas of Professional Expertise and Interest.
Paragraph 5: Any personal information you may want to divulge (family, hobbies, charity work, etc.)
Maximum character count 3000.
Additional Comments (Optional) Please provide any other information you would like considered with this RSA Membership Application.