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Friends of FACTS - Tell us more!
Connection to FACTS
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1.
Where did you first hear about FACTS (Fertility Appreciation Collaborative to Teach the Science)?
(Required.)
Personal connection (family, friend, etc.)
Physician or other healthcare professional
Medical student or resident
Other health professional student
FABM educator
School (please specify below)
FMEC (Family Medicine Education Consortium)
Conference (please specify below)
Website, Facebook, Twitter (please specify below)
Other
Other (please specify)
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2.
What is your association with FACTS? (Check ALL that apply)
I am a ...
(Required.)
FACTS Ambassador
FACTS Donor
FACTS Elective Student
FACTS Preceptor
FACTS Speaker
FACTS Volunteer
Facebook Friend and/or Twitter follower
Newsletter subscriber
Paid Student / Resident member ($20 / year)
Paid Associate member - e.g./FABM educator ($30/year)
Paid Professional member - e.g./Physician, allied health professional ($50/year)
Other (please specify)
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3.
How long have you been associated with FACTS?
(Required.)
Less than 6 months
6 months - 1 year
About 1 - 3 years
About 3 - 5 years
More than 5 years
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4.
What is your current role or occupation?
(Required.)
Medical Professional (Physician, NP, Mid-wife, PA, Nurse, etc.)
Medical Student, Resident, or Other Health Professional Trainee
FABM Teacher/Instructor
I work in another occupation (please specify)