Membership Checkout - My Green Doctor

Register Here as a Basic Green Member

After you register, we will email to you this certificate to demonstrate that your office or clinic has pledged to environmental sustainability. Please print several copies and purchase simple frames to display your certificate with pride in the waiting room, staff lunch room, and conference room. Email us if you would like to receive your certificate in a language other than English.

Membership Information

You have selected the Green Patron Member membership level.

Our Patrons support our work with an annual donation of $100 to the My Green Doctor Foundation that is tax deductible in the United

States. Thank you for supporting out work! Starting in 2025, Patrons are recognized in My Green Doctor’s Annual Report. Patrons have full access to My Green Doctor’s online resources.

$100 THIS IS A TAX-DEDUCTIBLE CHARITABLE DONATION IN THE US.

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Account Information

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Email Address

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Office name*

Type of office or medical practice*

Number of employees (including doctors)*

How did you hear about My Green Doctor?

Your healthcare organization membership, if any (choose one).

Full Name LEAVE THIS BLANK

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Make a Gift

Donation Amount

Please consider an additional tax-deductible contribution to the My Green Doctor Foundation, a 501(c)3 charitable foundation in the United States. Your donation of $100 will allow us to print 1250 educational brochures on sustainability and climate change for waiting rooms in practices in economically disadvantaged communities. Thank you.

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May we send you our short newsletter four times per year?

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