2023 RAD, White & Blue Radiology PAC Donation

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RAD, WHITE & BLUE RADIOLOGY PAC GIVING CAMPAIGN

Please contribute to the Virginia Radiology PAC Today! Help support the PAC in it's quest to build relationships with members of the Virginia legislature. These relationships enable us to have a voice as matters of concern to radiologists and physicians in general come before the legislature.

1
Full Name* This field is required.
First Name
Last Name
2
Physician Type?* This field is required.
Resident
Attending
3
What is your practice type?* This field is required.
Academic
Private Practice
Hospital-Based
Hybrid Academic/Private Practice
4
E-mail* This field is required.
5
Employer* This field is required.
6
Principal Place of Business (City, State)* This field is required.
7
Donation level:* This field is required.
$10
$25
$50
$100
$250
$500
Other
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