PM&R Knowledge NOW Patient Education Link Inquiry

Thank you for your interest in posting patient education materials on the PM&R KnowledgeNOW Patient Education section. Please note that this application is only for non-industry sponsored content. If you are a corporation interested in sponsoring content or advertising please contact corporatesupport@aapmr.org.

Please complete this form. We will review the information and contact you when a decision has been made. AAPM&R desires a robust site and thanks you for submitting content for review.

1. Please tell us a little about you and your organization

Company Name *This question is required.

Street Address

City

State

Zip

Contact First Name *This question is required.

Contact Last Name *This question is required.

Contact Title

Contact Email Address *This question is required. This question requires a valid email address.

Contact Phone Number *This question is required.

Organization URL *This question is required.

How did you hear about PM&R KnowledgeNOW?

2. What is the primary mission/purpose of your organization? (check all that apply) *This question is required.

Please enter an 'other' value for this selection.

3. Please provide your Tax Identification Number (TIN) and tax classification (501c3, etc.)

4. What patient education would you like to share? *This question is required.