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VAFP 2025 Winter Family Medicine Weekend – January 23-26
Required Human Trafficking Training
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Family Physician of the Day
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VAFP 2024 Scholarly Symposium
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Join a Committee
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VCU fmSTAT Scholars Program
fmSTAT Alums
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VAFP 2025 Winter Family Medicine Weekend
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2024 Adult Vaccine Schedule Changes
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April VMAP
Child Passenger Safety Provider Billing Guidance Cheat Sheet
804-968-5200
CLICK TO GET INVOLVED
admin@vafp.org
About
Board of Directors
Career Center
Contact Us
Mission & Vision
Staff Directory
VAFP Foundation
VAFP Magazine
Well-being Committee
VAFP 2024 Annual Report
VAFP Logo Apparel
Membership
Academy Awards
Committees
How to Join
Membership Benefits
Pay Your Dues
POEM Subscription
CME
VAFP 2025 Winter Family Medicine Weekend – January 23-26
Required Human Trafficking Training
NEJM Knowledge+ Pain Management Training
VMAP Provider Education
AAFP CME
Report My CME
Advocacy
Family Medicine Advocacy Rounds
AAFP Advocacy
Bill Finder
FamDocPAC
Family Physician of the Day
Find My Legislator
Speak Out
Become a VAFP Legislative Key Contact
Resident & Student
VAFP 2024 Scholarly Symposium
Choose Virginia Scholarships
Resident Spotlight
Resident & Student Lounge
Find a Mentor
Get Involved in the VAFP
Call for Nominations
2024-2025 VAFP Board
Resident and Student Directors
Join a Committee
AAFP Opportunities
VA Residency Programs
VA Medical Schools
VCU Welcomes fmSTAT Scholars
VCU fmSTAT Scholars Program
fmSTAT Alums
Loan Repayment Resources
Exhibits & Sponsors
VAFP 2025 Winter Family Medicine Weekend
What’s Current
VAFP News
Well-being Committee
2024 Adult Vaccine Schedule Changes
VDH Updates
VMAP
April VMAP
Child Passenger Safety Provider Billing Guidance Cheat Sheet
Become a VAFP Legislative Key Contact
Key Contact Survey
Key Contact Survey
Please provide the following information:
Name:
*
Practice Name
*
Home Address:
*
Home City/State/Zip:
*
Work Address:
Work City/State/Zip:
Email:
*
Phone Number:
*
How well do you know your home/workplace's district Delegate or Senator?
Not at All
Know by name only
Have had occasional direct contact with my Delegate or Senator
My Delegate or Senator is a patient of mine
Other (please specify)
Other (please specify)
Please list any legislators with whom you presently have a relationship.
Would you like to participate in VAFP sponsored activities in order to meet or expand your relationship with your Delegate or Senator?
Yes
No
Would you like to be a point of contact for your legislator on family medicine issues?
Yes
No
Are you a donor to FamDocPAC (Family Medicine's Political Action Committee)?
Yes
No, I've never heard of FamDocPAC
No, I don't care to make contributions to a PAC
No, I would consider giving, but I don't know what FamDocPAC does
No, I want to donate, but I don't know how to give to FamDocPAC
Are you aware of how the FamDocPAC is utilized?
Yes, I understand how FamDocPAC is used
Yes, but I would like to receive more updates on FamDocPAC activities
No, I need more information regarding how FamDocPAC is used
Which of the following FamDocPAC fundraising events would you be most likely to attend?
Evening/Weekend FamDocPAC Reception
FamDocPAC Golf Tournament
Regional Legislative Roundtable Discussions
I would not attend an activity; I would instead prefer email/telephone/mailing solicitations
Other suggestions (please specify)
Other suggestions (please specify)
Do you have any additional comments regarding the Key Contact Program or the FamDocPAC?
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