We encourage you to be specific about your learning goals and what best practices you can share with a peer as this will facilitate our ability to match you as appropriately as possible. Registration closes on March 22, 2023.

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* 1. Full Name

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* 2. E-Mail

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* 3. Organization Name

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* 4. What time zone are you located in?

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* 5. What is your current role in your AD program?

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* 6. Have you been trained in the communication techniques of academic detailing by NaRCAD?

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* 7. How many years of AD-related experience do you have (must have 1-year of AD experience to participate)?

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* 8. Please describe the communities you or your program works with and/or details (e.g., "I detail clinicians in rural communities in Maryland").

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* 9. Please describe your current AD-related responsibilities (e.g., materials development, detailing, training, etc.)

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* 10. Please tell us what you're hoping to learn from your peer (e.g. “learn to use data/metrics to build a robust evaluation plan” or “speak with someone who is also working on Hepatitis C screening/prevention”). Please be as descriptive as possible.

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* 11. Please tell us what you hope to share with your peer about your work (e.g., "share lessons learned from virtual detailing visits" or "share how our program reported data to stakeholders"). Please be as descriptive as possible.

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* 12. Any additional preferences that we should consider when creating your peer match?

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* 13. Are you available to attend our mandatory kick-off meeting on April 26, 2023, 2pm-3pm ET?

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* 14. Please include a bio to share with your peer match (around 100 words).

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* 15. Please upload a headshot to share with your peer match.

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