docSepember 2013 - Missouri State Chiropractors Association
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Sepember 2013 - Missouri State Chiropractors Association
Want to STOP a Malpractice Claim? Our Claims Advice Hotline May Stop a Claim in its Tracks At NCMIC, our Claims Advice Hotline staff has managed just about every type of allegation. They know chiropractic malpractice better than anyone and use this knowledge to confidentially guide doctors through potential claims situations. ousands of D.C.s have averted a claim aer calling the Hotline.* Stopping claims before they start is just one more way Call 1-800-769-2000, ext. 3120, to find out more. “We Take Care of Our Own.®” www.ncmic.com *Based on the claims data of NCMIC and its family of malpractice insurance companies since inception. We Take Care of Our Own is a registered service mark of NCMIC Group, Inc. and NCMIC Risk Retention Group, Inc. ©2013 NCMIC NFL 3520-2 MSCA Web Page ●● ● MSCA 2013 MEMBERSHIP APPLICATION If You’re Already A Member, Ask Another DC To Join! Name _____________________________________________________________________________________________________ Practice or Company Name ____________________________________________________________________________________ Office Address ______________________________________ Home Address ________________________________________ City/State/Zip ______________________________________ City/State/Zip ________________________________________ Office Phone _______________________________________ Home Phone _________________________________________ Fax Number ________________________________________ E-mail Address _______________________________________ Office County ______________________________________ Date of Birth _________________________________________ Chiropractic College _________________________________________________________________________________________ Graduation Date ____________________________________ If student, Expected Graduation Date ______________________ Date & State of First Licensure _________________________ Missouri License No. __________________________________ Select MSCA Membership Level The MSCA membership year is January 1 through December 31, 2013. Monthly Regular Member Fourth-Year DC Third-Year DC Second-Year DC First-Year DC 65 or Older Faculty Out-of-state Associate (non-DC) Student Quarterly Annually $33.33 $100.00 25.00 75.00 16.66 50.00 8.33 25.00 FREE FREE 16.66 50.00 16.66 50.00 8.33 25.00 16.66 50.00 ($25 one-time charge or $10 annually) $400.00 300.00 200.00 100.00 FREE 200.00 200.00 100.00 200.00 10.00 First-Year DC based on first year licensed in Missouri. I choose not to be a full member at this time, but would like to help the MSCA in it’s fight to defend, preserve and advance chiropractic for all chiropractors in the state of Missouri by contributing as a donor. Donor ($10-199) The tax deductible portion of your 2013 MSCA dues has been calculated to be 71%. The non-deductible percentage is 29% and relates to our lobbying activities. Method of Payment: Convenient payment plans are available. Dues can be automatically charged to your credit card semiannually or quarterly, or they can be debited from your checking account automatically every month. *Important: For your convenience, automatic monthly debits and quarterly charges continue annually. You may call to cancel at any time. **Checking Auto Debit: To start automatic debit from your checking, please call the MSCA office and a debit form will be sent to you. Please bill $____________ to my Annual (check or credit card) Visa MasterCard *Semi-Annual (credit card) Discover *Quarterly (credit card) **Checking Account **Monthly (checking auto debit) Credit Card Number _______________________________________________________________ Expiration Date __________________ Name as it appears on Credit Card ____________________________________________________ 3-Digit V-Code __________________ Signature ______________________________________________________________ Date ____________________________________ Make checks payable to MSCA and mail to: MSCA, 220 E. Dunklin, Jefferson City, MO 65101. Phone: 573-636-2553. Fax: 573-635-1470. Missouri State Chiropractors Assn. Political Action Committee (MSCA PAC) 2013-2014 PAC Membership Form July 1, 2013, through June 30, 2014 Name ______________________________________________________________________________________________ Office Address _______________________________________________________________________________________ City/State/Zip _______________________________________________________________________________________ Office Phone _______________________________________ Fax Number ___________________________________ E-mail Address _____________________________________ Please use credit card for payment plan option. Select PAC Membership Level PAC membership is an annual commitment from July 1, 2013, through June 30, 2014. Quarterly $ 250.00 Ambassador Membership Annually $ 1,000.00 Ambassadors are a prestigious group of chiropractic physicians committed to the advancement of chiropractic and have gone above and beyond the highest level of support through their generous contribution. Ambassadors receive special recognition at the PAC Reception during the MSCA Summer Convention. Scholar Membership 187.50 750.00 Diplomat Membership 125.00 500.00 Emissary Membership 62.50 250.00 Regular Membership 30.00 120.00 Scholar members are a distinguished group of chiropractic physicians committed to the advancement of chiropractic. Scholars receive special recognition at the PAC Reception during the MSCA Summer Convention. Diplomats are a dedicated group of chiropractic physicians committed to the advancement of chiropractic. Diplomats are recognized at the PAC Reception during the MSCA Summer Convention. Emissary members are a special group of chiropractic physicians who give something extra to help support the advancement of the chiropractic profession. Regular members are chiropractic physicians who actively support the advancement of the chiropractic profession. After you have paid your annual PAC membership, purchases at any PAC-sponsored event apply toward reaching the next higher level of membership. Certain individual political contributions may also apply toward reaching the next level of membership. Doctors are responsible for notifying the MSCA office when additional donations are made. MSCA membership is not required to become a PAC member. Method of Payment: Convenient payment plans are available. Dues can be automatically charged to your credit card semi-annually or quarterly. *Important: For your convenience, automatic credit card charges continue annually. You may call to cancel at any time. Please bill $____________ to my Annual (check or credit card) Visa MasterCard *Semi-Annual (credit card) Discover *Quarterly (credit card) Credit Card Number ______________________________________________________ Expiration Date _______________________ Name as it appears on card _________________________________________________ 3-Digit V-Code _______________________ Signature ________________________________________________________ Date ______________________________________ Make checks payable to MSCA PAC and mail to: MSCA PAC, 220 E. Dunklin, Jefferson City, MO 65101. Phone: 573-636-2553. Fax: 573-635-1470. Location: Hours: Send Registration to: Registration Information: Special Room Rates Available: 12 Hour Sessions 18 Hour Sessions* Checks payable to: Check Memo Should Note: Location: Hours: Send Registration to: Registration Information: Special Room Rates Available: 12 Hour Sessions 18 Hour Sessions* Checks payable to: Check Memo Should Note: Purification and Weight Management Program Are you overburdened, overweight, or overtired? The Standard Process purification programs utilize whole food supplements, pure food, and water to give the body the resources it needs so that it can purify and rebuild itself naturally. Hippocrates once said, “The natural healing force within each one of us is the greatest force in getting well.” Ignite the healing force. The Standard Process purification programs will help you achieve a higher level of health by cleansing the body from the inside out. SP Cleanse® - for purification SP Complete™ - for nutritious supplement shakes Gastro-Fiber® - for fiber support SP Green Food™ - for phytonutrients For more information, contact your Standard Process representative In eastern Missouri: Dawne Watters (800) 532-2128 In Western Missouri/Kansas: Jerry McFarland (816) 769-1043 REFRESH, REPLENISH, REJUVINATE MSCA Auxiliary Backbone of the MSCA Needs Your Support! Sign Up Your CA, Staff or Spouse Today! The MSCA Auxiliary actively supports every aspect of your professional association and needs your support to continue in its effort to provide . . . Scholarships to Chiropractic Students Memorial Services at Convention Servers for Lunch at Legislative Day Building Repairs for MSCA Headquarters Family Events at Convention MSCA Equipment Purchases & Repairs And Much More! Membership in the Auxiliary is only $25 for the entire year! If every doctor in the MSCA would sign up just one staff person, spouse or CA, it would bring in nearly $20,000 to support the MSCA and its mission. JOIN TODAY! Name: __________________________________________________ Please mail checks to: MSCA Auxiliary c/o Annette Copeland 411 Hwy 72 E Rolla, MO 65401 Phone: 573-341-8292 Address: _________________________________________________ City: _______________________________ State: ______ Zip: ____ Phone: ______________________________ Fax: ______________ Email: ___________________________________________________ Enclosed: ________________ ($25 made payable to MSCA Auxiliary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pecial MSCA Congratulations 2013 MSCA Summer Convention Golf Champions 1st Place A Flight (L to R) James McCartney, Dr. James Gray, James Wake, Dr. Donald Broman 2nd Place A Flight (L to R) Gina Robertson, Dr. Tom Robertson, Dr. Dennis James, Nathan Casillo 1st Place B Flight Dr. Keith Moeckel, Carolyn Furjes, Dr. Stephen Furjes, Dr. David Turnbull 2nd Place B Flight (L to R) Dr. James Scott, Rick Hemphill, Dr. Lee Richardson, Geoffrey Ackley Longest Drive Winner Dr. Donald Broman Closest to the Pin Winner Dr. David Turnbull � Pantone 255 Pantone 3015 Two Colour Assembly 51. 91 . 0 . 34 100 . 23 . 0 . 18 CMYK Assembly ® LOWER BACK PAIN RELIEF Pantone 255 Pantone 3015 Gray Scale Assembly E RE douts F Han t ble ien Pat availa • Designed for patient in-home use 30 Day conditional Money back guarantee LASHAW DISTRIBUTORS LTD. 9631 Bakerview Drive Richmond, B.C., Canada V7A 2A2 • Portable • Easy to use • Comfortable Tel: ....................................(604)270-4263 Fax:................................... 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