AAP FamilY Partnerships Network Application

Thank you for your interest in joining the American Academy of Pediatrics (AAP) FamilY Partnerships Network (FPN). The FPN is an advisory group to the AAP. Its mission is to represent family and youth/young adult perspectives, lead and facilitate youth/young adult and family engagement, and support ongoing youth/young adult and family involvement at the local, state, and national levels. This application is to join the broader network. Calls for nominations for the FPN Executive Committee are posted on annual basis.

Participation in the FPN provides you with the following:

Virtual community of youth/young adults/families, with opportunities to share best practices and lessons learned about partnering with pediatricians
Volunteer opportunities to add family perspectives to AAP programs and products, in partnership with pediatricians.

Question Title

* 1. Please provide your name and contact information.

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Which of the following best describes you? Please check all that apply.

Youth/Young Adult - "Typically Developing"

Youth/Young Adult with Special Health Care Needs

Parent of Typically Developing Child/Young Adult

Parent of Child/Young Adult with Special Health Care Needs

Sibling of Child/Young Adult with Special Health Care Needs

Grandparent

Guardian/Caregiver

Other (please specify)

Question Title

* 3. Are you a formal AAP Family Advisor (participating in a formal capacity at the AAP)?

Yes

Please enter the name of the group or grant program for which you are an AAP Family Advisor (eg Council on Children with Disabilities or Bright Futures Implementation Project).

Question Title

* 4. Are you a formal AAP Chapter Family Advisor (participating in a formal capacity with your State AAP Chapter)?

Yes

Please enter the Chapter name and briefly describe your role.