Below is a sample of the emails you can expect to receive when signed up to Support PROP.
Data Name | Data Type | Options |
---|---|---|
Are you a health professional?* | Text Box | |
First name | Text Box | |
Last name | Text Box | |
Text Box | ||
City | Text Box | |
State | Text Box | |
Country | Text Box | |
Country | dropdown | United States |
Province / Territory | dropdown | United States |
State / Province | dropdown | United States |
option | Are you a health professional?* | |
option | Yes | |
option | NoIf yes, please select | |
option | Dentist | |
option | Physician | |
option | Nurse | |
option | Physician's Assistant | |
option | Social Worker | |
option | Addiction Counselor | |
checklist | If a physician, please list your field(s) | |
checklist | Addiction Medicine | |
checklist | Allergy and Immunology | |
checklist | Anesthesiology | |
checklist | Colon and Rectal Surgery | |
checklist | Dermatology | |
checklist | Emergency Medicine | |
checklist | Family Medicine | |
checklist | Internal Medicine | |
checklist | Neurological Surgery | |
checklist | Neurology | |
checklist | Nuclear Medicine | |
checklist | Obstetrics and Gynecology | |
checklist | Occupational Medicine | |
checklist | Ophthalmology | |
checklist | Orthopaedic Surgery | |
checklist | Otolaryngology | |
checklist | Pain Medicine | |
checklist | Pathology-Anatomic and Clinical | |
checklist | Pediatrics | |
checklist | Physical Medicine and Rehabilitation | |
checklist | Plastic Surgery | |
checklist | Preventive Medicine | |
checklist | Psychiatry | |
checklist | Radiology-Diagnostic | |
checklist | Radiation Oncology | |
checklist | Surgery | |
checklist | Thoracic Surgery | |
checklist | Toxicology | |
checklist | Urology | |
option | Have you lost a loved one to an opioid overdose? | |
option | Yes | |
option | NoDid you become addicted to opioids while receiving treatment for pain? | |
option | Yes | |
option | NoIs someone close to you addicted to opioids? | |
option | Yes |