Basic information

This application requires uploading both a resume and a letter of recommendation. Please have both ready to upload when you start the application.
The Oregon Pain Management Commission (OPMC) is established within the Oregon Health Authority. The commission’s primary objectives are to:
      (a) Develop pain management recommendations;
      (b) Develop ways to improve pain management services through research, policy analysis and model projects; and
      (c) Represent the concerns of patients in Oregon on issues of pain management to the Governor and the Legislative Assembly.
 
OPMC is supported by staff from the Oregon Health Authority (OHA).
 
OHA's definition of health equity is "Oregon will have established a health system that creates health equity when all people can reach their full health potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, age, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances.
 
Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address:
 
The equitable distribution or redistribution of resources and power; and
Recognizing, reconciling and rectifying historical and contemporary injustices."

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* 1. The information you submit in this survey will be used by OHA staff and OPMC leadership to evaluate candidates' applications for membership and submittal to the OHA Director for review and appointment.  This information will also be used to promote diverse representation on OPMC. In addition, aggregate summary data for all those who respond may be reported publicly. Because of the small size of the OPMC applicant pool, it may be possible to identify how individual applicants have answered the survey from this aggregate information.

While you are not required to answer any questions about personal identities or health conditions, we encourage you to include information you are comfortable sharing to aid in our efforts to improve representation, with the understanding that this information may be disclosed (with personal information redacted according to the law) in the event of a public records request. 

If you require additional information about the confidentiality of this information, please email us at pmc.info@odhsoha.oregon.gov so we can address any questions before you fill out the survey.

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* 2. Please upload your resume or curriculum vitae. Acceptable formats include PDF, DOC, and DOCX. 

If you are having trouble, please email pmc.info@odhsoha.oregon.gov for help.

PDF, DOC, DOCX file types only.
Choose File

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* 3. Please upload a letter of recommendation. Acceptable formats include PDF, DOC, and DOCX. 

If you are having trouble, please email pmc.info@odhsoha.oregon.gov for help.

PDF, DOC, DOCX file types only.
Choose File

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* 4. Full Name

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* 5. Pronouns (optional)

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* 6. Email Address

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* 7. Phone Number

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* 8. Principal occupation or advocacy role (if any)

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* 9. Professional license type (enter NA if you are not a licensed healthcare provider)

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* 10. Other relevant memberships/affiliations (for example, board memberships, professional or service organizations)

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* 11. Please briefly explain why you are interested in serving on OPMC, and why you would be a good candidate for membership.

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