APDS/ARAS Announcement & Survey Request

APDS/ARAS accepts requests to distribute a survey or announcement for consideration to be incorporated into a future APDS/ARAS email blast. Requests must be submitted a minimum of 1 month before the requested distribution date to allow enough time for review. If accepted, the content will be approved for a one time distribution.

In order to submit a request, the following information must be provided below:

Contact Information
Brief explanation regarding the purpose for distribution to APDS members
Upload sample of desired content (word or pdf formats acceptable)
SURVEY REQUESTS ONLY
- Confirmation of Completion Pilot Study (5+ Physician Cohort)
- IRB Approval

Questions?
APDS@lp-etc.com | ARAS@lp-etc.com

1. Please complete your contact information: *This question is required.

First Name

Last Name

Company Name

City

State

Country

Email Address

Phone Number

2. Are you an APDS member in good standing? *This question is required.

If no, please list your company affiliation and title: *This question is required.

3. What type of request are you submitting? *This question is required.

What is the date of the event/educational activity you wish to promote? *This question is required.

5. What is the title of your survey? *This question is required.

6. In 350 words or less, please explain why the content of your survey/educational activity is relevant to APDS members and the purpose for seeking their potential participation: *This question is required.

Has this survey been piloted for clarity and timing with a cohort of at least five surgeons or physicians (medical students acceptable)? *This question is required.

Comments

Please upload IRB Approval for your requested survey (if applicable) (.pdf)

File: {{filename}} delete

7. Do you have a URL for your survey? *This question is required.

Please enter the URL to your survey

Please upload a copy of your survey (.pdf) *This question is required.

File: {{filename}} delete

8. Comments: