Application-Moving Medicine Partners
Introduction:
Based on your interest in joining MOVING MEDICINE PARTNERS, we invite you to complete the following application. Please review the initial membership requirements, determine the accurate membership option you qualify for,  and answer each question as thoroughly as possible. This will also aid us in directing incoming leads and referral business.

We understand we may be asking for sensitive information, and want to assure you that information received will be reviewed and discussed only by the Membership Committee, who have taken an oath to uphold the standards and confidentiality of all members and applicants. At no time will sensitive information be recorded or discussed outside of membership meetings.

Membership Options are Partner, Ally or Partner in Training. Read below to determine which best reflects you, and then proceed with the application.

1. Partner - $500
Requirements of PARTNER Membership
Must be married to (or longtime partner of) an MD or DO
Must have a minimum of $5,000,000 in sales volume in the previous year
Must have completed at least 5 physician transactions in your career.

2. ALLY - $500
Requirements of ALLY Membership:
Not married to an MD or DO
The city/territory you serve cannot already have a Partner representing the area
Must have a minimum of $5,000,000 in sales volume in the previous year
Must have completed at least 5 physician transactions in your career.
Limitations of membership: Note** As an Ally, you will not be listed publicly on the website nor will you be given access to use the Moving Medicine Partners logo or brand name as an affiliate. We are VERY protective of this brand being publicly represented by physician spouses as our primary marketing cornerstone. You will be our trusted referral ally for all referral needs in your territory.  

3. PARTNER IN TRAINING - $500
Requirements for PARTNER IN TRAINING STATUS:
Must be married to (or long time partner of) an MD or DO
You do not meet the threshold for minimum sales volume or physician transactions.
This status is good for new agents, part time agents, or agents that have just relocated to a new city.
The city/territory you serve cannot already have 3 Partners representing the area.
Limitations of membership: Note** Your contact information will not be publicly provided on the website. We want to ensure that clients will be connected with highly experienced agents when they come to us. You can receive referrals, but they will always be sent to the client with a caveat of your possible missing experience.
Which membership level do you qualify for?
Clear selection
Name (First and Last) *
City/Cities/Regions Served: *
States Served:
Email *
Phone number *
Brokerage Name
Managing Broker's Name *
Managing Broker's Email Address
How long have you been a licensed Realtor?
How many transactions did you complete in 2022?
What was your 2022 Volume?
Total Number of Physician Transactions in Your Real Estate Career.
Have you ever had your RE licensed suspended or revoked?
Clear selection
If so, please elaborate. 
Is your spouse or partner a physician?
Clear selection
If so, please provide their NPI number.
How are you actively growing your current pipeline of physician clients?
Do you have, or are you on a real estate team?
Clear selection
If yes, please elaborate.
What do you hope gain from being a Moving Medicine Partner?
How did you hear of Moving Medicine Partners?
Personal Website Link
Professional Facebook Page Link *
Your Instagram Handle *
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