Subject Matter Experts

Subject Matter Experts are definitive sources of knowledge who contribute their expertise to enhance education and organizational growth. The Consortium is looking for individuals who are willing to volunteer their time and expertise throughout the state.

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* 1. By completing this survey I agree to be contacted by the consortium or its affiliates as a subject matter expert.

Yes

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* 2. Contact Information (provide the best way to contact you)

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. What are your credentials?

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* 4. County willing to travel for in-person engagement (select all that apply).

Atlantic County

Bergen County

Burlington County

Camden County

Cape May County

Cumberland County

Essex County

Gloucester County

Hudson County

Hunterdon County

Mercer County

Middlesex County

Monmouth County

Morris County

Ocean County

Passaic County

Salem County

Somerset County

Sussex County

Union County

Warren County

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* 5. Years of Experience in Palliative Care

2-5 years

6-10 years

>10 years

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* 6. Content Expertise (select all that apply).

Advance Care Planning

Communication

Pain Management

Symptom Management (dyspnea, agitation, nausea/vomiting, etc...)

Cultural Aspects of Care

Care of the Imminently Dying

Ethical & Legal Aspects of Care

Other (please specify)

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* 7. Do you have previous experience with public speaking ?

Yes

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* 8. Do you feel comfortable with public speaking ?

Yes