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PreMed Prescription Rating
and Experience Program
APPLICATION FORM
Welcome to RateADrug.com's PPREP Application process. We appreciate your interest and look forward to processing your application. PPREP receives more applications than available slots for the program; application does not guarantee acceptance. All applications receive careful consideration and are kept strictly confidential.
RateADrug.com is an independent research organization. We are not affiliated with, nor do we accept advertising from, any pharmaceutical companies.
Contact Information
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Phone (zip code first):
Education
University or School:
Major:
 
Degree:
 
 
Experience and Activities
Are you currently employed in the health care field?
Describe any particular field of medicine or area of practice that you wish to focus on:
Describe any relevant research, internship or work experience:
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Achievements
Describe any special achievements, publications, awards or honors:
If available, attach any testimonials, references or published works, etc.
Attach another file
Describe your plans for collecting surveys
(e.g. set up a booth at a health fair, visit local nursing home, etc.):
I have read and agree to the PPREP Terms of Participation  
 




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