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PM&R Awareness Ambassadors

This unique program recognizes AAPM&R members who have positioned PM&R through media interviews, presentations in their communities or systems and/or presentations to other specialties.

Are you speaking with reporters about PM&R?
Delivering presentations about the value of the specialty to external audiences, such as primary care, hospital administration, etc.?

We want to recognize you!

1. Your Contact Information *This question is required.

First Name

Last Name

Title

Street Address

Apt/Suite/Office

City

State

Zip

Country

Email Address

Phone Number

2. Tell us more about how you are a PM&R Awareness Ambassador:

3. If other, please explain.

3. Who did you speak to about the value of PM&R? Who was the reporter and which outlet? *This question is required.

3. When was your interview with the reporter? *This question is required.

3. Was there an article published by the reporter/media outlet based on your interview? *This question is required.

Please enter an 'other' value for this selection.

3. If yes, please share a link to the article.

3. Who did you deliver your presentation to?

Please enter an 'other' value for this selection.

3. Where did you deliver your presentation? Please be as specific as possible. *This question is required.

3. Did you utilize AAPM&R's template slide deck to share a consistent message? *This question is required.

3. If applicable, please upload a copy of the presentation you delivered.

File: {{filename}} delete

3. What else would you like to share with us about your experience?