Medical Association of Southeast Louisiana
Member Engagement Survey

The Medical Association of Southeast Louisiana welcomes your involvement! By getting involved, you will reap professional rewards! Please note your interest in below. Thanks!

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* 1. Name

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* 2. Preferred Email Address:

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* 3. Preferred Phone:

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* 4. Please indicate your interest in being involved in any of the following ad hoc committees:

Women in Medicine

Early Career (8 years or less in practice)

Private Practice

Employed Physicians

Medical Education & Academic Physicians & Physicians-in-Training

Legislative & Regulatory

Education

Stakeholder Relations

Public Health & EMS Committee

Physician Wellbeing

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* 5. If you are interested in peer groups, please note areas of interest:

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* 6. If you are interested in mentoring opportunities, note your areas of expertise:

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* 7. Would you be interested in leadership opportunities within MASELA?

Yes

Medical Association of Southeast Louisiana Member Engagement Survey

Question Title

* 1. Name

Question Title

* 2. Preferred Email Address:

Question Title

* 3. Preferred Phone:

Question Title

* 4. Please indicate your interest in being involved in any of the following ad hoc committees:

Question Title

* 5. If you are interested in peer groups, please note areas of interest:

Question Title

* 6. If you are interested in mentoring opportunities, note your areas of expertise:

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* 7. Would you be interested in leadership opportunities within MASELA?

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* 8. If so, please describe your previous leadership experience (personal and/or professional):

Medical Association of Southeast Louisiana
Member Engagement Survey