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AAPCA1 Immigrant Child Health Committee - Join
Please complete this brief form to join the AAPCA1 Immigrant Child Health Committee.
1.
Practice Setting:
Community - private (solo or group)
Community - FQHC
Community - County Hospital
Academic setting
Other (please specify):
2.
Where are you in your career?
Medical Student
Resident
Fellow
In practice less than or equal to 10 years
In practice greater than 10 years
Emeritus/Retired
3.
Specialist vs Primary Care (please select one)
Primary Care
Specialist (list what kind below)
4.
What do you hope to get out of this task force?
5.
What ideas do you have for this task force?
(e.g. goals, activities, etc.)
6.
Which of the following working group(s) would you like to be a part of?
Education (focus on creating educational materials for clinicians and patients)
Legislative Advocacy (outreach to legislators, policy statements/op-eds, advocacy days)
Clinical Resources (focus on creating clinical tools to be used in practice)
Community Partnership (creating community partnerships to encourage collaboration)
Recruitment/Social Media (focus on recruiting new members and updating our social media sites with our activities)
*
7.
Full Name
(Required.)
*
8.
Email Address
(Required.)
Thank you for joining! We will be in touch with you soon.
