HVPMA
Houston Veterinary Practice Managers
Leading Managers to Success
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Please enter today's date *

 
Thanks for your interest in HVPMA.

What's your first name? *

 
What's your last name, *

 
Credentials
Please type in your answer if you select "other" *


 
Please fill in your Hospital's Name? *

 
Please fill in your Hospital's  Street Address? *

 
Please fill in the City in which your Hospital is located? *

 
Please fill in your State in which your Hospital is located? *

 
Please fill in your Hospital's Zip Code? *

 
Your Hospital's telephone number? *

 
Your Hospital's fax number?

 
Please provide us with the First and Last Name of your Practice Owner.

 
Length of Time with this Title? *


 
Number of Direct Reports *

Please select the number of employees that report directly to you

 
Length of Employment at Current Practice? *


 
Length of Time in the Veterinary Field? *


 
Length of Time in the Veterinary Management? *


 
Length of Time as a member of HVPMA? *


 
How did you here about our organization?


 
If you were referred to this group, please tell us who referred you and what company/hospital they work for.   Include the person's first and last name.

 
If you are an existing member, please tell us what you like most about being a member?

 
If you are an existing member, please tell us what you like least about being a member and how this could be improved?

 
If you are an existing member, please tell us how many of the RACE Approved REGIONAL CE meetings did you attend? (please use a numerical number)

 
If you are an existing member, please tell us how many of the RACE Approved BI-ANNUAL CE meetings did you attend? (please use a numerical number)

 
Please list at least 3 and as many as 5 CE topics you would like presented at either one of our monthly REGIONAL meetings or Bi-Annual meetings.

 
How likely are you to refer another manager or team lead to the association with 0 being NOT AT ALL and 10 being ABSOLUTELY ?

 
Please select the type of membership for which you are applying. Select only one answer. Membership fees are prorated. {{var_price}} *


 
Are you applying for a Group Membership? *

     
 
Are you a Team Lead applying for Group Membership? *

     
 
How will your membership dues be paid?


 
Are you a Practice Manager/Administrator paying membership dues for a Group? *

     
 
Please indicate the Number of Team Leads to include in the Group Membership Dues. *


 
Please enter the First and Last Name of ALL Team Leads applying for Group Membership? **If you have more than one Team Lead Member, please number them as follows: 1., 2., 3., etc *

 
Please indicate the number of Additional Managers applying for Group Membership. **Please number them as follows: 1., 2., 3., etc. *


 
Please list the First and Last Names of All Additional Managers applying for Group Membership. **If there is more than one Team Member, please number them as follows: 1., 2., 3., etc. *

 
Membership Dues: {{answer_wjjhiH2bnjlT}} *

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**If you are applying to this group for the first time OR if you are requesting to be moved from the Team Leads group to the Managers group as a result of a promotion, you will need to complete the TASK ANALYSIS. Please click the link below to complete the Task Analysis.** https://hvpma.typeform.com/to/BdvjuE
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