* 1. Please select your current role.

* 2. If you are a practicing PA, how many years of clinical experience do you have?

* 3. What do you consider your clinical area of expertise?

* 4. How many cumulative years experience do you have with global health? (ie: practicing medicine, going on/organizing trips, education on public health issues, working on research projects related to global health, etc...)

* 5. I have gone on a global health trip outside of the US:

* 6. If you answered yes to #5, what was the nature of your trip? (check all that apply)

* 7. What was the length of your Global Health trip (cumulative for all combined trips)?

* 8. If you have practiced medicine outside of the US, in what capacity have you practiced? (check all that apply)

* 9. Who have you practiced medicine with outside of the US? (check all that apply)

* 10. Please list the countries you have traveled to for medical work/volunteering. 

* 11. Are you interested in writing an article for our quarterly NEXUS newsletter? 

* 12. What topics are you interested in writing about / reading about? ( check all that apply)

* 13. Are you interested in volunteering for a specific PAGH project and being assigned to a task force?

* 14. If you answered yes to #13, what type of tasks/projects are you interested in? (check all that apply)

* 15. Are you interested in being listed in our PAGH Network Directory? This will be available to our members upon request as being a point of contact for the countries/areas you have experience with or by offering advice to those who are inquiring about shared special interests that you have.

* 16. What would you like to see as a benefit from your PAGH membership? (check all that apply)

* 17. What topics are you interested in learning more about? (check all that apply)

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