The South West Regional Psychosocial Oncology Community of Practice

Please join our PSO Community of Practice

Thank you for taking the time to let us know you are interested in participating in the South West Regional Psychosocial Oncology Community of Practice.

We will be in touch soon regarding the first meeting.

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* 1. What is your full name?

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* 2. What is your email address?

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* 3. What is your phone number?

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* 4. What is your profession?

Social Worker

Dietitian

Psychologist

Psychiatrist

Occupational Therapist

Physical Therapist

Mental Health Counselor/Therapist/Specialist

Sexual Health Counselor/Therapist/Specialist

Director/VP

Administrator/Management

Other (please specify)

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* 5. What interests you in participating in SWRCP’s Psychosocial Oncology CoP?

Learning and professional development

Regional communication and networking opportunity

Staying current in the field (technology, best practices, new studies, etc.)

Solutions to real-life work challenges

Expand personal and professional network

Systematically review work with peers before, during, and after implementation

Other (please specify)

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* 6. Please let us know where you currently practice psychosocial services?

Hospital

Community

Cancer Center

Private Practice

Other (please specify)

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* 7. Please tell us what organization you currently practice psychosocial services in. Please provide mailing address.

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* 8. What method of communication do you prefer most and think would be most effective for the Psychosocial CoP?

Virtual CoP (Primarily online through a website, socials, and email)

In-person

Telephone conferences

Mixed approach (all of the above)

Other (please specify)

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* 9. Please select your preferences for attending various networking functions.

Networking luncheon

Networking dinner

Events which include guest speaker, learning sessions and talks

Informal social networking events

Other (please specify)

Question Title

* 1. What is your full name?

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* 2. What is your email address?

Question Title

* 3. What is your phone number?

Question Title

* 4. What is your profession?

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* 5. What interests you in participating in SWRCP’s Psychosocial Oncology CoP?

Question Title

* 6. Please let us know where you currently practice psychosocial services?

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* 7. Please tell us what organization you currently practice psychosocial services in. Please provide mailing address.

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* 8. What method of communication do you prefer most and think would be most effective for the Psychosocial CoP?

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* 9. Please select your preferences for attending various networking functions.

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* 10. Please provide any recommendations to strengthen our CoPs’ effectiveness.