Please complete the survey below to submit up to three (3) resolutions per FAFP policy.

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* 1. Today's Date

Date
Time

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* 2. Physician AAFP/FAFP Member Number:

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* 3. Cell Phone Number:

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* 4. Email address:

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* 5. The following resolution(s) is being submitted for consideration to:

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* 6. Please upload your draft resolution(s). As a reminder, each author is limited to no more than three resolution submissions annually. FAFP staff will be in contact with you within five (5) business days in order to begin the resolution vetting process as described.

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