The global institute for the education, certification, and advancement of pain physicians.
WIP EXECUTIVE BOARD
President
Kris C. P. Vissers (Netherlands)
MD, PhD, FIPP
President-Elect
Craig T. Hartrick (USA)
MD, DABPM, FIPP
Honorary Secretary
Philippe Mavrocordatos
(Switzerland)MD, FIPP
Honorary Treasurer
Muhammad Ather (UK)
MD FRCA FIPP FFPMRCA
Immed. Past President, Founder
Richard L. Rauck (USA)
MD, FIPP
Editor-in-Chief, Pain Practice
Craig T. Hartrick (USA)
MD, DABPM, FIPP
Chair, Board of Examination
Peter S. Staats (USA)
MD, MBA, FIPP
Chair, Section Board
Jan Van Zundert (Belgium)
MD, PhD, FIPP
Chair, Advisory Board
Athina Vadalouca (Greece)
MD, PhD, FIPP
Founders/Past Presidents
Serdar Erdine (Turkey)
MD, FIPP
Gabor B. Racz (USA)
MD, DABIPP, FIPP
Ricardo Ruiz-López (Spain)
MD, FIPP
STAFF
Executive Officer/Board Secy.
Dianne L. Willard (USA)
Managing Director/Education & Certification Programs
D. Mark Tolliver, MA (USA)
In Memoriam
P. Prithvi Raj
MD, DABIPP, DABPM, FIPP
(Sept 13, 1931 – Feb 27, 2016)
Founding Father & Past President / December 2016
WORLD INSTITUTE OF PAIN®
MEMBERSHIP DUES INVOICE 2017
With Payment Options details (page 2) and optional paper forms (pages 3-4)
Dear WIP Member:
As the World Institute of Pain®begins a new year of serving the global community of pain physicians who share our commitment to the standardization and advancement of multidisciplinary interventional pain practice, all of us who were selected by the membership to serve as leaders and facilitators of the WIP mission would like to say, thank you, for choosing to be a sustaining member of WIP and hope you will renew your commitment for 2017 (see details on next page).
Through your support, WIP is able to deliver high-quality educational and certification programs that bolster the efficacy and safety of interventional pain techniques. Through our network of members like you, together we help signify to people throughout the world that it is the right of every human being to have access to the best pain relief in each and every part of the world.
Thanks to your support, WIP delivered this year another successful World Congress in New York, USA that brought both members and non-member supporters together for focused learning and professional networking. We are already planning our next World Congress in 2018, which will be in Dublin, Ireland. We delivered hands-on workshops in New York, USA and Budapest, Hungary; culminating in examinations that certified 35 new physicians as Fellow of Interventional Pain Practice® (FIPP®) and 8 new physicians as Certified Interventional Pain Sonologist (CIPS), bringing our total certifications to 969 and 34, respectively; representing some 56 member countries. Additionally, WIP endorsed educational conferences and workshops in countries of Argentina, Brazil, United Kingdom, and the USA; and in 2018 we will return to The Netherlands to the city of Nijmegen for one of our premier activities organized by the WIP Benelux Section. Three certification exam dates are scheduled in the Miami, Florida, USA; Nijmegen, Netherlands; and Budapest, Hungary. We also eagerly anticipate ALGOS 2017 in Rhodes Island, Greece for the International Symposium organized by the WIP Mediterranean Section. The journal of PAIN Practice continues to be a world-class scholarly publication, accessible now via mobile app in addition to traditional digital and print subscriptions.
As a member of WIP, you will receive a digital subscription to PAIN Practice that includes mobile app accessibility; deeply discounted offer to continue your print subscription to the journal; discounted registration to many WIP-sponsored conferences and workshops; discounted registration to the WIP World Congress.
To renew membership, go to: Membership tab.
Thank you!
WORLD INSTITUTE OF PAIN®
Kris C.P. Vissers, MD, PhD, FIPPCraig T. Hartrick, MD, DABPM, FIPP
PresidentPresident-Elect
WORLD INSTITUTE OF PAIN®
MEMBERSHIP DUES PAYMENT OPTIONS
Dear WIP Member:
Membership dues are $195* and may be paid electronically with major credit card; check (US dollars); or bank wire (contact WIP for details).
To renew your membership in WIP, you have several options:
1)Online: Login via – then click on the “Membership” tab, then first subtab for “Join/Renew Membership,” and login with your WIP user ID and PW.
Pay with major credit card: Visa, MasterCard, or American Express.
If you have forgotten your login ID/PW, or need further assistance with online renewal, please contact Dianne Willard at .
2)Mail – Check: Mail a check in US Dollars drawn on a US bank to the World Institute of Pain, 150 Kimel Park Dr Ste 100A, Winston-Salem, NC 27103 USA.Be sure to include your name somewhere on your check!
3)Mail or FAX: Use attached form. Fax number: 336-760-2981. Address above.
4)Bank Wire: For certain international members with payment restrictions, a bank wire is sometimes more effective. Contact Dianne for instructions, if interested in this payment method.Be sure to include your name somewhere on your wire!
Anyone interested in renewing multiple years (or as alternative if have forgotten your login ID/PW), you may pay online as follows:
5)Online: Instead of logging in as a member, access this “special payment link” online: and enter the following amounts in the WIP Membership Fee/Invoice Payment field:
One Year$195Four Years$730.00
Two Years$375Five Years$900.00
Three Years$550
6)Mail – Check/FAX: Amounts same as above.Be sure to include your name on the check!
7)Bank Wire: Amounts same as above. Contact Dianne for instructions, if interested in this payment method. Be sure to include your name somewhere on the wire!
*Qualifying members of developing and under-developing countries may receive a $30 annual discount on membership dues. Please contact Dianne Willard to verify eligibility and payment method.
Thank you!
World Institute of Pain
Membership Application & Renewal Form
To initiate a new or renewal membership in WIP, either complete the ONLINE application accessible via the WIP Web site or complete this form and send it to the WIP Secretariat.WIP membership includes a digital subscription to PAIN Practice, the official journal of WIP.
/ Digital subscription to current issue and all back issues (2001 to present), including World Congress abstract supplements and early-view articles!Login via (top of screen), click on journal image on home page, then click on link to PAIN Practice journal website.
PLUS, mobile app – both Apple and Android system versions available.
Download from applicable Apple and Google stores.
Login ID and PW are the SAME for both. Current membership required.
CHECK HERE IF YOU CONSENT TO BE INCLUDED IN DIRECTORY,
ACCESSIBLE BY MEMBERS ONLY
Name
Address
City / State/Province
Country / Postal Code
E-mail Address * REQUIRED * PLEASE INCLUDE EMAIL ADDRESS * / Telephone Number
Facility Type: Hospital University Pain Center
Specialty: Anesthesiology Oncology PM&R
Internal Medicine Orthopedic Surgery Psychiatry
Neurology Pain Medicine Surgery, General
Neurosurgery Pharmacology Other ______
Annual Dues:$195 USDCheck here to join/renew for TWO years: $375 USD
Payment options: Check (USA-bank) MasterCard Visa American Express
Card Number Expiration Date CVV Number
Name on Card
Today’s Date Signature
Thank you!
WIP SECRETARIAT – E-mail: / Fax: +1.336.760.2981
World Institute of Pain®
OPTIONAL – WIP MEMBER
PRINT SUBSCRIPTION ORDER FORM
Tocontinue receiving the PRINT subscription of the journal PAIN Practice, in addition to your complimentary digital subscription as the member benefit, please authorize payment or send payment for the $200 member subscription fee. Thank you!
/ Digital subscription to current issue and all back issues (2001 to present), including World Congress abstract supplements and early-view articles!Login via (top of screen), click on journal image on home page, then click on link to PAIN Practice journal website.
PLUS, mobile app – both Apple and Android system versions available.
Download from applicable Apple and Google stores.
Login ID and PW are the SAME for both. Current membership required.
Name
Address
City / State/Province
Country / Postal Code
E-mail Address * REQUIRED * PLEASE INCLUDE EMAIL ADDRESS * / Telephone Number
MEMBER PRICE FOR PRINT SUBSCRIPTION$200 USD(one year subscription)
(This price is ONLY applicable to current WIP members / members in good standing.)
Payment options: Check (USA-bank) MasterCard Visa American Express
Card Number Expiration Date CVV Number
Name on Card
Today’s Date Signature
WORLD INSTITUTE OF PAIN
150KimelParkDrive• Suite100A• Winston-Salem,NC27103-6992USA
Board/Member Services Tel:1+336-760-2933 •Fax:1+336-760-2981 | Education/Certification Tel:1+336-760-2939 •Fax:1+336-760-5770
Email: Email: