A Step Up to Rheumatology Sign Up
We are happy to be providing this course free of charge currently. We are finishing the final touches on the course following our beta-phase. Please fill out this form and our team will be in touch soon with your access code.
Name
*
First Name
Last Name
Practice name:
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
APP type
*
NP
PA
PharmD
NP student
PA student
PharmD student
Other
Would you like a complimentary membership to RhAPP?
*
Yes
No
Would you like to be connected to a mentor? (Mentors are experienced RhAPP faculty)
*
Yes
No
How many years of experience do you have in rheumatology?
*
0-1
1-3
3-5
5-10
>10
On a scale of 1-10 how confident do you feel managing patients with PsA?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with axSpA (AS & nr-axSpA)?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with SLE?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with gout?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with RA?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with vasculitis?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with inflammatory myopathies?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel managing patients with pediatric rheumatologic conditions?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
On a scale of 1-10 how confident do you feel prescribing medications to your patients?
*
Worst
1
2
3
4
5
6
7
8
9
Best
10
1 is Worst, 10 is Best
How many patients do you see per week?
*
How did you hear about A Step Up to Rheumatology?
*
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