The Northeast Region Service Project and American Kidney Fund Partnership Survey
We are interested in your passion and commitment to Kidney Health Promotion and Prevention in the local communities we serve. We greatly appreciate you taking the time to share your thoughts.
Sisterly,
Stacey Johnson, DNP, MSN, BSN, RN, CCM
Northeast Region Assistant Regional Director
Chi Eta Phi Sorority, Inc.
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Northeast Region of Chi Eta Phi Sorority, Inc.
1. How much do you support or oppose The Northeast Region Service Project and the  American Kidney Fund Partnership? *
2. Are you interested in becoming a trained and certified Kidney Health Coach by the American Kidney Fund? *
3. For Chapter Anti-Basileus: Are you willing to lead your chapter, in an active participation, in  the Northeast Region Service Project and the American Kidney Fund Partnership? (Minimum of 2 community engagements per year.)
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4. Are you interested in becoming a Kidney healthcare clinician subject matter expert for the The American Kidney Fund and the Northeast Region Service Project Partnership? *
5. Are you interested in becoming a Peer to Peer reviewer, to review The American Kidney Fund created health education content, and/or develop online kidney health continuing education courses for The American Kidney Fund and the Northeast Region Service Project Partnership? *
6. Do you have 1 year or more of current clinical renal/kidney disease management experience? *
If Yes, Please Specify the current work setting, your title and years in your role to date:
7. Will you be attending our 68th Leadership and Education Conference in Dover Downs, Delaware and present on Saturday 4/18/20? *
Name: First and Last *
Chapter name and what position are you most active in your chapter *
Your best method of contact information *
Thank you for completing the survey!
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