The Unbranded Doctor Network

Yes! Please add me to  the National Physicians Alliance network of Unbranded Doctors.

By joining this network, I am asserting my interest in helping to reduce the influence of pharmaceutical marketing on medical reserach, education, and practice.

Prefix*  Dr. Mr. Ms. Dr. and Ms. Dr. and Mr. Drs. Mr. and Ms. Prof. Rev.

First Name*

Last Name*

Email*

Street

Street 2

City*

State/Province*       Select a state   Alabama   Alaska  American Samoa  Arizona  Arkansas  California  Colorado  Connecticut  Delaware  D.C.  Florida  Georgia  Guam  Hawaii  Idaho  Illinois  Indiana  Iowa  Kansas  Kentucky  Louisiana  Maine  Maryland  Massachusetts  Michigan  Minnesota  Mississippi  Missouri  Montana  Nebraska  Nevada  New Hampshire  New Jersey  New Mexico  New York  North Carolina  North Dakota  Northern Mariana Islands  Ohio  Oklahoma  Oregon  Pennsylvania  Puerto Rico  Rhode Island  South Carolina  South Dakota  Tennessee  Texas  Utah  Vermont  Virgin Islands  Virginia  Washington  West Virginia  Wisconsin  Wyoming         Armed Forces (the) Americas         Armed Forces Europe         Armed Forces Pacific  Alberta  British Columbia  Manitoba  Newfoundland and Labrador  New Brunswick  Nova Scotia  Northwest Territories  Nunavut  Ontario  Prince Edward Island  Quebec  Saskatchewan  Yukon Territory  Other

Zip/Postal Code*

Phone

Do you hold an MD or DO degree, or a license to practice medicine in the United States?*  M.D. D.O. I am not a physician. I am a medical student

Please select your specialty from the following pull down menu.  Allergy and Immunology Anesthesiology Dermatology Emergency medicine Family medicine Internal medicine, general Internal medicine/Pediatrics Internal medicine, subspecialty Neurology Obstetrics/Gynecology Pathology Pediatrics, general Pediatrics, subspecialty Physical medicine and rehabilitation Preventive medicine, general Preventive medicine, subspecialty Psychiatry Radiology Radiation oncology Surgery, General Surgical subspecialty Other medical specialty (specify below) Not Specialized

Other Specialty/Subspecialty

Please keep me as a friend/member of the NPA

I understand that none of my contact information will be shared or sold without my consent.*

 

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