Urge Medical Society of Virginia to Oppose Assisted Suicide Please use this survey to indicate your interest level in advocacy to oppose the legalization of assisted suicide. Question Title * 1. Profession Physician Physician Assistant Resident Fellow Medical Student PA Student Question Title * 2. Name (First and Last) Question Title * 3. Email Question Title * 4. Daytime Phone Question Title * 5. Mailing Address - City or County Question Title * 6. Mailing Address - Street Question Title * 7. Mailing Address - State Question Title * 8. Mailing Address - Zip Question Title * 9. Are you a registered, dues-paying member of the MSV? Yes No No, but tell me how I can join. Done