| Title | Start Date | End Date | Amount |
|
YES, I Volunteer to Serve as a Mentor (AMSSM Active/Associate Members only) |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
YES, I Volunteer to Serve as a Mentor (AMSSM Active/Associate Members only) |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
YES, I Volunteer to Serve as a Mentor (AMSSM Active/Associate Members only) |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
YES, I Volunteer to Serve as a Mentor (AMSSM Active/Associate Members only) |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
YES, I am a Resident or Medical Student and Would Like to Meet with a Mentor |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
YES, I am a Resident or Medical Student and Would Like to Meet with a Mentor |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
YES, I am a Resident or Medical Student and Would Like to Meet with a Mentor |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTOR'S ONLY: Primary Specialty
Q: Please indicate your primary specialty in the box provided.
R: Family practice |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTOR'S ONLY: Primary Specialty
Q: Please indicate your primary specialty in the box provided.
R: Family Medicine |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTOR'S ONLY: Primary Specialty
Q: Please indicate your primary specialty in the box provided.
R: Family Medicine |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTORS ONLY: Preferred Number of Mentees
Q: Please indicate the number in the box provided.
R: 1-4 |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTORS ONLY: Preferred Number of Mentees
Q: Please indicate the number in the box provided.
R: 2 Mentees |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTORS ONLY: Preferred Number of Mentees
Q: Please indicate the number in the box provided.
R: 2 mentees |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTOR'S ONLY: Time Availability
Q: Indicate all sessions you are available in the box provided (Session #1, #2, #3, & #4).
R: session 1 |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTOR'S ONLY: Time Availability
Q: Indicate all sessions you are available in the box provided (Session #1, #2, #3, & #4).
R: Session #1,#2 |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
MENTOR'S ONLY: Time Availability
Q: Indicate all sessions you are available in the box provided (Session #1, #2, #3, & #4).
R: Session #2, #3 |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
RESIDENT/MEDICAL STUDENTS ONLY: Level or Year
Q: Indicate in the box provided which number best describes you.
R: I am attending physician. Graduate in 2007; however, I am applying for a Primary Care Sports Medicine Fellowship in July. |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
RESIDENT/MEDICAL STUDENTS ONLY: Level or Year
Q: Indicate in the box provided which number best describes you.
R: 2 |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
RESIDENT/MEDICAL STUDENTS ONLY: Level or Year
Q: Indicate in the box provided which number best describes you.
R: 1 |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
RESIDENTS/MEDICAL STUDENTS ONLY: Time Availability
Q: Indicate all sessions you are available in the box provided (Session #1, #2, #3, & #4).
R: Session #1 is most convenient as I am enrolled in several ICLs. However, I will of course make myself available for whichever times are most convenient for the mentor. |
Apr 14, 2015 | Apr 17, 2015 | $0.00 |
|
RESIDENTS/MEDICAL STUDENTS ONLY: Time Availability
Q: Indicate all sessions you are available in the box provided (Session #1, #2, #3, & #4).
R: Session #1, #2, #3, & #4 |
Apr 14, 2015 | Apr 17, 2015 | $0.00 |
|
RESIDENTS/MEDICAL STUDENTS ONLY: Time Availability
Q: Indicate all sessions you are available in the box provided (Session #1, #2, #3, & #4).
R: #1 #3 #4 |
Apr 14, 2015 | Apr 17, 2015 | $0.00 |
|
RESIDENTS/MEDICAL STUDENTS ONLY: Primary Speciality
Q: Please indicate your primary specialty in the box provided.
R: Emergency Medicine |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
RESIDENTS/MEDICAL STUDENTS ONLY: Primary Speciality
Q: Please indicate your primary specialty in the box provided.
R: Family Medicine |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |
|
RESIDENTS/MEDICAL STUDENTS ONLY: Primary Speciality
Q: Please indicate your primary specialty in the box provided.
R: Family Medicine |
Apr 14, 2015 | Apr 19, 2015 | $0.00 |