Pharmacist Survey

We want to hear from you regarding your views on the importance of protecting the pharmacy profession in Arizona.

* Demographics

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	B.S	Pharm.D.
Pharmacy Professional Degree

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If "Other", please state.

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	University of Arizona	Midwestern University	Other
Institution where Pharmacy Degree was earned

If "Other", please state.

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If "Other", please state.

	Owner	Employee
If an Independent Retailer, I am:

* My County of Residence is:

* Questions

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
AzPA, by working with the Arizona Board of Pharmacy is able to express pharmacists' views concerning various aspects of the profession, thus impacting pharmacy regulations.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
AzPA, by working with the Colleges of Pharmacy, is able to express pharmacists' views concerning pharmacy education.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It is important for the profession of pharmacy to have a state organization to promote the interests of the profession.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It is important for the profession of pharmacy to have a state organization with a large membership.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It is important for the profession of pharmacy to have an organization which monitors the professional environment to assure that changes do not occur which are detrimental to the interests of the profession or to individual pharmacists.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
I am NOT content to allow someone else to carry the responsibility of assuring that the profession of pharmacy will continue to exist in such a way that I will remain a vital healthcare professional.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It is important that AzPA continue to provide vital information on issues impacting my profession.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It is important that AzPA continue to provide qualilty continued education programs to pharmacy professionals.

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	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree
It is important to have the opportunity to network with other colleagues in the state.

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	Half-empty	Half-full
If a 16 ounce bottle contains 8 ounces of liquid, I consider it to be:

If you ARE A MEMBER of AzPA, please answer the following questions:

I belong to AzPA because:

I find the following services and features of AzPA to be the most valuable to me:

I find the following services to be of little or no value to me:

I would like to see the following changes in AzPA:

If you ARE NOT A MEMBER of AzPA, please answer the following questions:

I choose not to belong to AzPA because:

I would consider joining AzPA if the following changes were made:

If you would like to be entered into the drawing for the $100 American Express Gift Card, please provide the following information:

First Name:

Last Name:

Title:

Company/Organization:

Email address:

Best Contact Phone Number:

Address:

City:

State:

Zip:

OPTIONAL: If you have additional comments or would like to be contacted regarding AzPA membership, please include them in this space.

Thank you for completing the AzPA Pharmacist Survey. Upon submission, you will be entered into the $100 gift card drawing.

* Indicates Response Required