Application for Membership

Strengthening Our Reach and Impact through AAHomecare Membership

"Being a member of AAHomecare has not only supported our organization in becoming stronger to take care of our community, but it has also helped us to network across the nation, developing relationships with other providers who are seeing similar situations in their regions and working together to come up with solutions that are better for the industry as a whole"

Cheryl Henninger,
Geroulds Healthcare Center/ Community Care Health Soluitions

HME Revenue Annual Dues
Under $600,000 $550
$600,000 - $1,000,000 $900
$1,000,001 - $2,500,000 $1,450
$2,500,001 - $5,000,000 $2,850
$5,000,001 - $7,000,000 $4,000
$7,000,001 - $10,000,000 $5,800
$10,000,001 - $20,000,000 $8,000
$20,000,001 - $40,000,000 $12,000
$40,000,001 - $70,000,000 $20,000

Corporate Partners

Bronze $25,000
Silver $40,000
Gold $50,000
Platinum $60,000
Diamond $75,000
Legacy $125,000

Company Information

Company Name:
DBA (Directory Listing):
Primary Contact:
Title:
Email:
Number of Locations:
Annual Homecare Revenue:
Mailing Address:
City:
State:
ZIP:
Phone:
Website:
Company Administrator
(*This person can edit company profile and contacts, receive invoices, etc.):
Company Administrator Title:
Email:
NPI(s)
(NOTE If more space is needed for NPIs, please upload as cvs or xls to minau@aahomecare.org)::
Business Type (Select One):
Business Mix (Check all that Apply):

Council Interest

AAHomecare advisory councils provide a forum for members with common interests to play a leadership role in AAHomecare programs, advocacy, communications, andeducation. Please indicate the council(s) on which you or a staff member would be interested in serving.:

Breastfeeding Coalition

Signature:
Date:

Membership Dues

Member dues are based on a company’s gross annual sales revenue in all categories of home medical equipment, services, and supplies generated by all of the company’s business locations and divisions. Membership dues are the largest part of the Association’s annual budget. Accurate reporting of your company’s revenue is critical if the Association is to continue working on the many issues that challenge the HME industry. If your company is not directly involved in the supply, distribution, and/or manufacturing of home medical equipment – but rather, is a supplier of ancillary services to the HME industry – dues are based solely on gross annual revenues for the company. Dues payments to the American Association for Homecare are not deductible as charitable contributions for federal income tax purposes. However, such payments may be deductible under other provisions of the Internal Revenue Code. Federal law states that a portion of your dues (currently 35%) for lobbying is not deductible. HME Dues Card # Exp. Date
By the signature affixed below, I hereby certify that the information submitted in this application is true, complete, and correct to the best of my knowledge and belief.
Signature:
Date:
After submitting this form, a team member will reach out to complete your membership payment. Full membership and benefits will be activated once payment has been received.