Provider Membership Renewal (Custom)

Renew your membership to continue accessing essential resources, education, and advocacy opportunities in palliative care. Complete the renewal form to maintain your connection to a community dedicated to improving care for patients and families.

Renew your dues by completing the form below:

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Name of Organization(Required)

Name(Required)

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Email(Required)

Phone(Required)

Member Dues

Note: The minimum membership renewal dues for hospices is $200. Please ensure you reach the minimum amount to submit payment.

Dues Amount ($)(Required)

Please enter the lump sum dollar amount below.
Dues period is from January 1st through December 31st. IL-HPCO is basing dues on previous year admissions, unless your admissions have declined, then we honor a lower rate for dues billing.

Please consider an additional contribution to support the work of IL-HPCO, a 501c (3) organization.

Total Amount to be Billed

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