Doctors For Designated Driving

Get Involved
As a physician, I recognize my ability to lend a credible voice to activities that contribute to the improvement of the community through the betterment of public health. I wish to have my name signed as a supporter of the founding principles of Doctors For Designated Driving; that designated driving should be publicized more effectively, and that businesses which choose to serve alcohol should offer incentives to patrons who elect to be designated drivers.
 
In signing this agreement, I understand that Doctors for Designated Driving will never publish anything about me beyond my name, city, degree (M.D. or D.O.), specialty and state. My email will never be sold to anyone for any use. Doctors for Designated Driving will send a maximum of 4 emails per year, one each quarter, to update me on the organization’s accomplishments. I will never, as a result of signing, be asked to make a financial contribution to Doctors for Designated driving. I also understand that I can still sign-up without giving my email.
 
First Name
Middle Initial
Last Name
   

City

State
         
Degree
M.D.   M.P.H.
  D.O.   M.S.W./C.S.W.

M.D. Medical Student
  N.P.
 
D.O. Medical Student
  O.T.
  D.D.S.   P.A.
  M.D./PhD.   P.T.
  M.D./M.P.H   D.P.M.
  P.H.D.   R.N.
  Pharm. D/RPH    
 
   
  Specialty or Expected Year of Graduation
 
  Email