Patient for Patient Safety Network Asia Pacific (PFPSN-AP)

Share Your Story

You might have a direct experience with patient safety or medical error. We wish to convey our heartfelt condolences to everyone who has lost a loved one, has been personally affected, or has cared for someone whose safety was compromised. We’d also like to invite you to join us as patient advocates fighting to prevent unnecessary patient harm and death through the #Uniteforpatientsafetymission. Your story will play an important role in carrying the Patient Safety mission forward. Please consider sharing your experience with us, and we will post it on our website so that patient safety is not compromised.Please fill the form below and we will contact you.

Your Information

First Name

Last Name

Phone

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City

Country

Organisation Name (If Applicable)

Organisation Website (If Applicable)

First Name (Featuring Person)

Last Name (Featuring Person)

Your story (in detail)

Acknowledgement- I hereby authorize Patient Academy for Innovation and Research (PAIR Academy) and assign the rights to use the information to public relations efforts. I authorize the practice to use my name, brief biographical information and the Testimonial. I understand and approve the disclosure of testimonial information to other individuals and entities that maybe involved in the initiative. *

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