Florida Psychoanalytic Center

Membership Application

Membership Applications

Instructions for using the fillable PDF forms above:

  • Adobe Reader (free) or Acrobat Pro must be used to fill out the form.
  • Apple Preview, a web browser’s built in PDF reader, or any other PDF viewer will not work.
  • Right-click (Mac users: ctrl-click) and choose “Save as…” to prevent the web browser from automatically opening the form in another viewer.

Complete the form, print, sign, and return. Or, simply print the form, fill it out by hand, and return it.

Membership Dues

Pay your membership dues online with credit card, bank account, or PayPal account:

Or send a check to the address below.

Return forms and dues to:

Florida Psychoanalytic Center
4649 Ponce de Leon Blvd. Suite 303
Coral Gables, FL 33146
Telephone: (305) 669-4353
Fax: (305) 740-4449
Email: fl.psychoanalytic.center@gmail.com