May 16, 2008
Confidentiality Agreement: AMSA will keep your identifiable information strictly confidential, unless you give us permission to use it. Please include your name or email in your submission so that we may contact you regarding your story. However, we will accept anonymous submissions. For more information, contact AMSA's Legislative Affairs Director, at (703) 620-6600 x 211.
AMSA is working on various initiatives and would truly appreciate your input and experiences pertaining to any of the following topic areas (please select one of the following areas in which you have an experience to convey):
Name: (confidential) School: (confidential) Email: (optional) Tell us your story:
Can AMSA use your story as part of our initiatives in these areas? Yes No
Can The New Physician contact you regarding your story? Yes No