State Chapter Email List Policy

Agreement

This form must be completed by ASMBS State Chapter Presidents (or their designees) to request access to member or potential member email addresses within their respective state. The purpose of this form is to ensure that all data requests and related communications comply with ASMBS privacy and data protection policies. Upon request, ASMBS will provide State Chapters with an email contact list of Society members residing in the state or geographic region in which the chapter is located, at no cost. All requests are reviewed and approved by the ASMBS National Office before any contact information is released or any communication is distributed. The email contacts provided by ASMBS may only be used by the State Chapter and its representatives for official State Chapter business—such as event announcements, membership recruitment, advocacy efforts, and educational outreach—and may not be used to advertise or promote a surgical or medical practice or any event not sponsored by the State Chapter and/or ASMBS. Each State Chapter must include an opt-out mechanism in all communications and must promptly report any opt-out requests to the ASMBS Membership team. State Chapter Presidents assume full responsibility for ensuring compliance with this policy.

Section 1: Requestor Information

Name(Required)

Section 2: Purpose of Request

What is the purpose of this email request?(Required)
Indicate whether this message will be sent:(Required)

Section 3: Audience Requested

Please select the audience you are requesting contact information for:(Required)
Requested delivery format:(Required)

Section 4: Compliance and Confidentiality Attestations

Each requestor must acknowledge the following statements:

  • I understand that all ASMBS membership data is the property of ASMBS and may only be used for official state chapter business.
  • I agree not to share, sell, or distribute any contact information to third parties or outside organizations.
  • I understand that all communications must comply with ASMBS privacy, and anti-spam policies, and that commercial or political solicitations are prohibited.
  • I agree that any communication using ASMBS data must be educational, advocacy-related, or membership-related in nature.
  • I will ensure that any email distribution includes an opt-out mechanism for recipients.
  • If any recipient requests to opt out of future communications, I will promptly forward their name and email address to the ASMBS National Office so that their member profile can be updated accordingly.
  • All communications sent as a result of the requested list will be sent with the Chapter CCing the ASMBS Membership team at membership@asmbs.org.
  • I understand that failure to comply may result in revocation of data access privileges.
Agreement to Terms(Required)

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