National Primary Care Week (NPCW)- Planning Committee Interest Form

Welcome, Chapter Officers! We are so thrilled to invite you to participate in this unique advocacy opportunity to serve as a Planning Committee member for National Primary Care Week (NPCW) '26! As apart of this role, you will be pivotal in creating the schedule of this week of action, including coordination of speakers, activities, and key content areas that you feel are essential advocacy components linked to primary care advocacy. We are so excited to have you. Please do not hesitate to reach out to donya.ahmadian@amsa.org with any questions!

About You

Your Name(Required)

First Last

Pronouns

Your Email Address(Required)

Email Address Confirm Email Address

AMSA ID

For the AMSA ID, helper text used elsewhere is: If you have a six-digit AMSA ID, you can enter it here. Have an AMSA ID but don't know it? You can find it here: https://amsa.org/get-amsa-id or text AMSAID to 615-265-0086 (U.S. only).

AMSA Chapter/Institutional Affiliation

Are you available to commit to roughly 1-2 hours/week of support leading into NPCW on October 4th-10th?

Yes

Not at this time but keep me in mind for future events!

Are you available to commit to facilitating NPCW events at your local chapter?

Yes

Not at this time but keep me in mind for future events!

Does your chapter take part in the following activities throughout the leadership year? There is no right or wrong answer to these questions, as we are only looking to understand our chapters more intimately 🙂

Monthly in-person or virtual meetings

Consistent events throughout the semester

Consistent communication with your chapter throughout the semester

Please list any questions or additional reflections here(Required)

National Primary Care Week (NPCW)- Planning Committee Interest Form

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