Engage with CPhA Survey

Question Title

* Demographics and contact information

First Name

Last Name

Job Title

Company

Credentials (e.g., PharmD)

City

Province/Territory

Pronouns

Email Address

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* Do you belong to your provincial pharmacy association?

Yes

Unsure

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* Do you belong to any other pharmacy associations?

Yes

Unsure

If yes, please specify:

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* Meetings with governments and stakeholders: We regularly meet with federal MPs to discuss the important role of pharmacy in our communities and a range of more specific topics and issues. We are always seeking passionate pharmacists to include in these meetings. Would you like to participate in a stakeholder meeting if one is arranged in your riding?

Yes

If yes, please provide your postal code(s) at home and at work, and any specific topics you are intersted in:

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* Speaking opportunities: We regularly host discussion panels and educational webinars and are often seeking front-line pharmacists to provide their perspectives. We are also always looking for new and engaging speakers for our national conference. Are you interested in discussing speaking opportunities?

Yes

If yes, please list the topics (both advocacy/policy and specific clinical areas) that you have expertise in / would be interested in speaking on and share any relevant experience:

Engage with CPhA

Question Title

* Demographics and contact information

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* Do you belong to your provincial pharmacy association?

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* Do you belong to any other pharmacy associations?

Question Title

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* Do you have any other thoughts to share or ways you’d like to engage with us?