Please fill out the information in the form below to contribute to SDSMA PAC.
  • SDSMA PAC promotes the improvement of government through the active participation of physicians and others.
  • SDSMA PAC works to elect candidates who promote and support high-quality patient care, comprehensive medical education and the establishment of high standards of medical care.
  • SDSMA PAC is a separate, segregated fund created by the SDSMA to impact public policy through bipartisan participation in all aspects of the political process. SDSMA PAC is a non-profit organization, and membership is voluntary. 
  • Membership is available to physicians, spouses of physicians, residents, medical students, members of the South Dakota Medical Group Management Association (SDMGMA) and SDSMA staff. Candidates for membership are subject to approval by the SDSMA PAC Board of Directors.

Board of Directors

SDSMA PAC is a separate segregated fund established by the South Dakota State Medical Association. Contributions are not limited to suggested amounts, and the South Dakota State Medical Association will not favor or disadvantage anyone based on contribution amounts or the refusal to give. SDSMA PAC contributions should be in the form of a personal check or personal credit card. Contributions are not deductible as a charitable contribution for federal income tax purposes.

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Contact Information

*First name
Middle Name/Initial
*Last name
*Primary Email
This email is where all SDSMA communication will be sent to.
Alternate Email
Primary Phone

Work Information

Employment Start Date

Home Information

Home/Cell Number
Home Address
Home Address 1
Home City
Home Zip Code

Personal Information

Date of Birth
Spouse's Name
if applicable
Maiden Name
if applicable
 Payment frequency
*Donation Type
Select your donation.

PAC Membership Levels:
•Chairman's Club $1,000
•Senate Club $500
•House Club $350
•PAC Member $200
•PAC Resident $50
•PAC Student $25
*Amount ($USD)
• PAC contributions & Foundation donations are counted in the year received.
If you selected multiple donation types, please specify where funds should be allocated.

If SDSMA Foundation is selected, please specify a specific scholarship fund if desired.

South Dakota State Medical Association
2600 W 49th St Ste 100
Sioux Falls, SD 57105
Phone: 605.336.1965 | Fax: 605.274.3274

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