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?* | ![]() | |
First name | ![]() | |
Last name | ![]() | |
![]() | ||
City | ![]() | |
State | ![]() | |
Country | ![]() | |
Country | ![]() | United States |
Province / Territory | ![]() | United States |
State / Province | ![]() | United States |
![]() | Are you a health professional?* | |
![]() | Yes | |
![]() | NoIf yes, please select | |
![]() | Dentist | |
![]() | Physician | |
![]() | Nurse | |
![]() | Physician's Assistant | |
![]() | Social Worker | |
![]() | Addiction Counselor | |
![]() | If a physician, please list your field(s) | |
![]() | Addiction Medicine | |
![]() | Allergy and Immunology | |
![]() | Anesthesiology | |
![]() | Colon and Rectal Surgery | |
![]() | Dermatology | |
![]() | Emergency Medicine | |
![]() | Family Medicine | |
![]() | Internal Medicine | |
![]() | Neurological Surgery | |
![]() | Neurology | |
![]() | Nuclear Medicine | |
![]() | Obstetrics and Gynecology | |
![]() | Occupational Medicine | |
![]() | Ophthalmology | |
![]() | Orthopaedic Surgery | |
![]() | Otolaryngology | |
![]() | Pain Medicine | |
![]() | Pathology-Anatomic and Clinical | |
![]() | Pediatrics | |
![]() | Physical Medicine and Rehabilitation | |
![]() | Plastic Surgery | |
![]() | Preventive Medicine | |
![]() | Psychiatry | |
![]() | Radiology-Diagnostic | |
![]() | Radiation Oncology | |
![]() | Surgery | |
![]() | Thoracic Surgery | |
![]() | Toxicology | |
![]() | Urology | |
![]() | Have you lost a loved one to an opioid overdose? | |
![]() | Yes | |
![]() | NoDid you become addicted to opioids while receiving treatment for pain? | |
![]() | Yes | |
![]() | NoIs someone close to you addicted to opioids? | |
![]() | Yes |