OSPA 2025 PA Day at the Capitol Registration
April 9, 2025
Name
*
First Name
Last Name
Credentials (i.e. PA-C, RN, MSN)
Email
*
example@example.com
Mobile Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company:
Job Title
What city do you practice in?
What legislative district do you reside in? If you do not know, the lookup tool can be found here: https://www.oregonlegislature.gov/FindYourLegislator/leg-search.html
Submit
Should be Empty: