POMA Podcast Idea Form

Thank you for you interest in the POMA DOes podcast series! Please use this form to submit your episode idea and provide as much detail as possible.

Question Title

* 1. Contact Information

Name

Email Address

Phone Number

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* 2. Please share you ideas for the episode:

Topic

Who is the target audience?

Have the episode participants been identified? If yes, please provide names. If no, please let us know what kind of individuals you think should participate.

Do you have a target release date in mind? If yes, when?

Do you intend to make this episode eligible for CME credit?

Is the idea generated from a committee? If yes, which one?

Question Title

* 3. Additional comments you'd like to share.

Thank you for your ideas! Information submitted on this form will be shared with POMA's Technology Workgroup who is charged with developing POMA's podcast. Brenda Dill (Team POMA) will follow-up with you after the group discusses the submission.