IPPS Member Spotlight

Welcome to the IPPS Member Spotlight Program

IPPS members are diverse, unique, and accomplished individuals dedicated to improving the lives of persons living with persistent pelvic pain. This program was created to highlight the many contributions and accomplishments of IPPS members. So basically, we want to celebrate YOU!

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* 1. By submitting your information you give the IPPS permission to share this information on the IPPS website, social media, and other types of publications.

I understand and agree

I DO NOT agree

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* 2. Please enter your contact information:

First Name and Lat Name

List all your professional degrees

Address

Address 2

City/Town

State/Province

Country

Email Address

Phone Number

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* 3. Are you currently an IPPS member? Please note, if your membership is not active or expired, you cannot be featured in this program. To activate or update your membership, please go to www.pelvicpain.org.

Yes

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* 4. Briefly tell us about your expertise and accomplishments. You may consider describing your practice or any research or community projects that you developed or participated. Projects should be described if they've had a positive impact on the pelvic pain community. You can also showcase educational projects.

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* 5. Tell us about your educational background. For example where did you complete your medical training including fellowships and post graduate degree?

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* 6. Where do you currently practice and what type of patients do you treat? You may also find it helpful to describe your area of expertise here.

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* 7. If you've made any major contributions to the IPPS, please describe them here. For example, if you participate in any IPPS committees or board, of if you've done other IPPS projects, please list them here.

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* 8. Please upload a brief CV or resume

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

Choose File

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* 9. Please upload a high definition professional picture of yourself.

PNG, JPG, JPEG file types only.

Choose File

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* 10. The information you provide will be used to create a member spotlight that will be featured on social media. Please list any handles (e.g. Facebook, Twitter, Instagram) or hashtags that you want included in our promotion.

IPPS Member Spotlight

Welcome to the IPPS Member Spotlight Program

Question Title

* 1. By submitting your information you give the IPPS permission to share this information on the IPPS website, social media, and other types of publications.

Question Title

* 2. Please enter your contact information:

Question Title

* 3. Are you currently an IPPS member? Please note, if your membership is not active or expired, you cannot be featured in this program. To activate or update your membership, please go to www.pelvicpain.org.

Question Title

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* 5. Tell us about your educational background. For example where did you complete your medical training including fellowships and post graduate degree?

Question Title

* 6. Where do you currently practice and what type of patients do you treat? You may also find it helpful to describe your area of expertise here.﻿﻿

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* 7. If you've made any major contributions to the IPPS, please describe them here. For example, if you participate in any IPPS committees or board, of if you've done other IPPS projects, please list them here.﻿﻿

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* 8. Please upload a brief CV or resume

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* 9. Please upload a high definition professional picture of yourself.

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* 10. The information you pro﻿﻿vide will be used to create a member spotlight that will be featured on social media. Please list any handles (e.g. Facebook, Twitter, Instagram) or hashtags that you want included in our promotion.

* 6. Where do you currently practice and what type of patients do you treat? You may also find it helpful to describe your area of expertise here.

* 7. If you've made any major contributions to the IPPS, please describe them here. For example, if you participate in any IPPS committees or board, of if you've done other IPPS projects, please list them here.

* 10. The information you provide will be used to create a member spotlight that will be featured on social media. Please list any handles (e.g. Facebook, Twitter, Instagram) or hashtags that you want included in our promotion.