MdPHA Database of Public Health Professionals

As this pandemic unfolds, public health professionals are more urgently needed and appreciated than ever. 

Whether you are a student or seasoned, please complete this survey to add your name to the Maryland Public Health Association’s (MdPHA) Database of Public Health Professionals. This is the first database of its kind to identify and differentiate the wide range of public health professionals residing in Maryland who can support rapid response efforts now, and into the future. Public health professionals have a broad range of skills, we understand disparities better than most, and we can aid in effective planning. We want to help. We can help. We can serve as the new MD Public Health Action Alliance.   -Please complete this survey to join us.

If you have questions, email: getinfo@mdpha.org 


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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Are you a: ? (check all that apply)

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* 4. What is/are your degrees (as of 2020)?

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* 5. If you have certifications, please list them: 

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* 6. What is your current job title/position or are you a student?

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* 7. Who are you employed by, or if you are a student, what academic institution do you attend?

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* 8. Where do you live?

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* 9. What county do you live in?

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* 10. What is your public health expertise? (check all that apply)

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* 11. If you are a public health medical provider, what type?

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* 12. How many years of training and experience do you have?

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* 13. What is your subject area? (check all that apply)

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* 14. What languages can you use for work?

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* 15. Are you comfortable working with any of the following? (check all that apply)

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* 16. Would you be willing to help with any of the following immediate needs for a COVID-19 response?

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* 17. What is your email address?

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* 18. Can we contact you by phone/text? If yes, please include your phone number:

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* 19. Are you a member of MdPHA?

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* 20. Other thoughts or comments? How would you like to help and what is your availability?

To submit this survey, press "DONE" below  
The Maryland Public Health Association (MdPHA) would like to thank you for your incredibly valuable contributions. To join the MdPHA, visit:  https://mdpha.org/become-a-member/  If you have questions, email getinfo@mdpha.org    

Together, we will make a difference.

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