Sign Up Form to Join APTA DC HEART (Health Equity & Anti-Racism Team)
Please sign up if you would like to receive emails or texts related to upcoming HEART efforts. We ask that anyone wishing to join express an interest in social justice and health equity. Meetings occur every other Tuesday from 6PM -7PM via Zoom. Please email us at
advocacy@aptadc.org
for any questions.
Name
Your answer
E-mail Address
Your answer
Phone Number
Your answer
Do you wish to receive text messages to the phone number listed above? Text messages will only be used for meeting reminders/updates to planned events. You are welcome to opt out at any time.
Yes
No
Clear selection
Please list your employer(s) or PT school affiliation below. This information is being collected to assess which hospitals, universities, clinics, schools, etc are being represented and for networking purposes.
Your answer
Are you currently an APTA member?
Yes
No
Clear selection
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms