Associate & IL Membership

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Company Name

Your Name(Required)

First Last

Your Email(Required)

Your Phone Number

Billing, A/R Contact Name (for membership dues renewal)(Required)

First Last

Billing, A/R Contact Email Address(Required)

Billing, A/R Contact Phone Number(Required)

Address

Street Address Address Line 2 City State Zip Code

Phone

Website

Company Category

Management and Operations

Please check only one

Accounting – Cost Reporting/Payment/Data Analysis; Financial Services; Group Purchasing

Education & Training

HR/Staffing

Legal Services

Marketing

Risk Management/Insurance

Technology – Security/Monitoring; IT

Facility Maintenance

Please check only one

Construction Management – Emergency Preparedness and Life Safety Code; Engineering, Design & Architecture; Environmental Supplies & Services; Fire Safety; Furniture; Heating & Cooling; Restoration & Remodeling

Housekeeping & Laundry

Resident Care

Please check only one

Behavioral Health

Food Service

Hospice/Palliative Care

Home Health

Lab/Dialysis Services

Medical Supplies & Equipment

Nutrition and Fitness

Health Services – Oral; Vision; Dental; Podiatry

Physician Services

Rehabilitation/Therapy

Wound Care

Pharmaceuticals

Key Staff Information

IHCA/INCAL offers a wealth of resources that are exclusively developed for our members. To maximize your membership benefits, it is important that you provide us with the contact information of key staff members of your facility who should receive access to IHCA/INCAL’s suite of digital communications resources including a self-serve member portal, e-newsletters, toolkits, on-demand education offerings, and more. Please use the “plus sign” on each field to add a row to input additional contacts.

Please use the "plus sign" on each field to add a row to input additional contacts.

First Name

Last Name

Title/Designation

Email Address

Associate Member Dues

Dues for Associate Membership are collected on an annual basis and provide Associate Members benefits from the date of membership approval by the IHCA Board of Directors to December 31. Information about non-deductible dues can be found: https://www.ihca.org/membership/associate-membership/

Please Select Your Membership Level

Please contact Colin Hebenstreit at chebenstreit@ihca.org regarding availability of Title membership*.

Standard Member – $750

Key Member – $2,500

Title Member* – $12,500

Agreement and Payment

I agree to the privacy policy.

I understand that submission of this application is not a guarantee of IHCA membership and that this application must be approved by the IHCA Board of Directors. Approval of membership does not constitute endorsement by the IHCA of applicant or its products and/or services. I understand that membership benefits are only to be used by the applicant and its employees and that any misuse of membership rights and benefits may result in membership termination. If this application is approved, IHCA may use applicant’s information in IHCA electronic membership directory, and applicant consents to receive communications via regular mail, email, telephone, and/or fax sent by or on behalf of IHCA. Payment of Associate Member Dues must accompany this application and will be processed upon receipt. Payment will be refunded if membership is denied.

Associate & IL

Associate Membership Opportunities:

Company Category

Key Staff Information

Please use the "plus sign" on each field to add a row to input additional contacts.

Associate Member Dues

Your Questions Matter