Toward PrEP Access for All

2024 © Southern AIDS Coalition

Southern Policymaker Academy

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Last Name*

Pronouns

Title

Affiliation*

City*

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Do you have any access requirements we should be aware of?

Food allergies/ preferences

Are you a physician, physician assistant, nurse practitioner, clinical nurse specialist, nurse anesthetist, or certified clinical nurse midwife?*+

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If yes, please enter your NPI number+

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+Please be aware that if you are a licensed US physician, nurse practitioner, or physician assistant, meals provided in connection with this meeting may be reportable under the Federal Open Payments / Sunshine Act.

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Southern Policymaker Academy