Registration

This form is an application for membership in CPIC. You will get a confirmation of your registration and the CPIC administrative team will review your application. You will receive a follow-up message once your application has been reviewed.

New User RegistrationChoose a Username*

First Name*

Last Name*

Institution*

City & State/Province*

Country*

Member Group*

Email*

Assistant’s Email (only provide if you want someone else to receive CPIC notification emails for you, e.g. for calendaring meetings)

Is your institution currently involved in implementation of CPIC guidelines as part of its clinical pharmacogenetics program?

If yes, and you are willing to be listed on the CPIC Implementers page, please provide one or both of the following: institution and website OR contact name and email. (Note: If you are a commercial laboratory, you must first submit your information to the Genetic Testing Registry at http://www.ncbi.nlm.nih.gov/gtr/docs/submit/ and supply the GTR URL to be listed on the implementers site. Send email to contact@cpicpgx.org with the GTR URL.)

*Required field