LUGPA Practice Showcase: LUGPA Practice Leadership Challenge Submission Form

LUGPA is seeking insights from practice leaders who have successfully addressed significant challenges rapidly and with limited financial resources. Your experiences will help inform and inspire other practices facing similar hurdles. If selected you will develop a 4 to 5 minute video highlighting these solutions and it will be viewed at the Annual Meeting. You also will be invited to attend the in-person session to answer questions on November 8, 2025.

Deadline for submissions: September 9, 2025

Question Title

* Practice & Leader Information: Please provide your full name, title/role, LUGPA practice name, email and phone number.

Full Name:

Title/role:

LUGPA Practice Name:

Practice Location (City/State):

Email Address:

Phone Number (Cell Phone or Direct Line):

Question Title

* Detailed Challenge Response (Challenge 1)
For each challenge, please complete the following:
- Title of Challenge (e.g. staffing shortage)
- Description of the problem (What was the issue?/how urgent?)
- Solution(s) implemented (What actions were taken?)
- Time to implement (e.g. less than 72 hours/1 week)
- Outcome/impact (What was the result?/How did it help your practice)

Question Title

* Detailed Challenge Response (Challenge 2)
For each challenge, please complete the following:
- Title of Challenge (e.g. staffing shortage)
- Description of the problem (What was the issue?/how urgent?)
- Solution(s) implemented (What actions were taken?)
- Time to implement (e.g. less than 72 hours/1 week)
- Outcome/impact (What was the result?/How did it help your practice)

Question Title

* Detailed Challenge Response (Challenge 3)
For each challenge, please complete the following:
- Title of Challenge (e.g. staffing shortage)
- Description of the problem (What was the issue?/how urgent?)
- Solution(s) implemented (What actions were taken?)
- Time to implement (e.g. less than 72 hours/1 week)
- Outcome/impact (What was the result?/How did it help your practice)

Question Title

* Reflections: What key lessons did you or your team learn from solving these challenges?

Question Title

* Consent: By submitting this form, I agree that LUGPA may use this information for educational, promotional, or peer-sharing purposes. I understand I may be contacted for additional details or clarification.

I Agree.

Question Title

* Signature (Typed name accepted as digital signature):

Question Title

* Please enter the date of submission.

Date:

Date

Thank you for your submission. You will be notified if you have been selected after September 9, 2025.