WISAM Public Policy Committee Interest Form
WISAM is looking for individuals who are interested in becoming more involved in the Public Policy Committee. Our current Chair, Dr. Elizabeth Salisbury-Afshar, is ready to help lead a team with a keen interest in public policy matters around issues that affect addiction medicine, the practice of addiction medicine, and public policies that may impact the social determinant of health for our patients. Please complete the form below in order to get connected and learn more about the opportunities we have available to get involved.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Area Code
Phone Number
Organization/Employer
We are going to aim for quarterly meetings with the Public Policy Committee and would appreciate your insight on availability. Please select the following that may be applicable to your schedule:
Wednesdays - 12:00 PM (Noon)
Wednesdays - 7:00 PM
Wednesdays - 8:00 PM
Other
Comments/Questions:
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