AAP Shot@Life Program Sign-up

Sign up to join the AAP Shot@Life in-office program

 
As a founding partner of the UN Foundation’s Shot@Life Campaign, the Academy mobilizes pediatric leaders to support and accelerate vaccine access goals. Working with Shot@Life provides pediatricians the opportunity to talk to the public and the U.S. government about the critical role of vaccines in saving and improving the lives of children around the world. The American Academy of Pediatrics spreads the message that all kids deserve a shot at life and offers resources to help pediatricians educate about the importance of international vaccine-prevention programs. The Academy provides accurate technical health information to the campaign and seeks to ensure all children have access to vaccines.

The Academy and Shot@Life believe there is an opportunity to educate Americans about global vaccines at a critical moment: in the pediatrician’s office while getting their children vaccinated. While we understand the constraints – time and others – during in-office interactions with moms and kids, we hope to provide pediatricians and their staff tools to educate families without a big investment in time or resources.

When you sign up to take part in this in-office program, we will send your practice a toolkit with resources to help you promote global vaccines, including posters, information cards and Shot@Life gear.

PLEASE NOTE: if you have more than one practice site, please enter the additional address and contact information in questions 5 and 6.

The Shot@Life materials are currently only available for individuals residing in the United States. If you are interested in downloading resources from the campaign, please visit www.giveashotatlife.org and click on "Tools."
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1. Name
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2. Size of practice: how many patients do you see each month for vaccinations?
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3. In what type of area is your practice located?
4. Please describe the type of practice you have. For example, community practice affiliated with hospital, private practice, public health clinic, etc.
5. Do you have an additional location that you would like to receive materials?
6. If you have a second practice that you would like to receive materials, please fill out the name, address and main contact for the second office.
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7. Who will be the main point of contact for this project?
8. How did you hear about Shot@Life?
9. If you heard about Shot@Life from the AAP, from which source did you hear about it?
10. Are you a member of an AAP committee/section/council? If so, which one?
11. Please provide a short description of how you plan to use the materials in your office (e.g. where posters will be hung, how staff will be involved, etc.)
12. In addition to raising awareness for Shot@Life through this program, each practice can choose to fundraise for Shot@Life as well. When patients learn about Shot@Life, many want to know how they can help. Donating is a quick and easy way that people can take action to save lives.

If you choose to fundraise at your practice, we will send additional materials to recognize donors and promote donations. Are you interested in fundraising at your practice?
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