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Raise Your Voice

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Raise Your Voice -- Advocacy Questionnaire Form

The advocacy process begins with you! Bring an issue forward by completing the
Member Advocacy Questionnaire Form below.

What is an Advocacy and Technical Practice Issue?
There are four categories of issues; Legislative, Regulatory, Internal Policy, or External Policy.

  • External policy is a policy or a procedure of a standard setting organization or
    other agency (not NCRA). 
  • Internal policy is an NCRA policy or procedure. 
  • Regulatory describes issues that are a state or federal law tied to regulatory enforcement
    by a state of federal agency. 
  • Legislative describes issues that are a state or federal initiative or action tied to
    congress or state legislature.

 
Full Name: *
Email: *
Phone: *
Mailing Address:
City:
State/Province:
Zip/Postal Code:
Country:

Are you a Member of NCRA?
Yes
No
Do you have the CTR credential?
Yes
No
Location of facility where you work (ST/Prov):
Type of facility where you work:
Other (please be specific):
What is the issue/concern you would like to address? *
Why is this issue/concern a problem? *
In what ways does it affect your work? *
How often does this issue/concern affect your work? *
Daily
Couple times a week
Couple times a month
Other
Other (please be specific)
Where do you see this problem coming from? (Examples: State Legislature, Hospital administration, standard setting organizations.) *
What would you like to see happen/be changed? *
Any ideas/solutions on how to fix the issue/concern? *