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Chapter Book Club - Join
Please complete this brief form to join the Chapter Book Club.
*
1.
Full Name
(Required.)
*
2.
Email Address
(Required.)
3.
Where are you in your career?
Medical Student
Resident
Fellow
In practice less than or equal to 10 years
In practice greater than 10 years
Emeritus/Retired
4.
What do you hope to get out of this book club?
5.
What ideas do you have for this book club?
(e.g. goals, activities, etc.)
6.
Do you have any book recommendations?
If so, please list them below:
Thank you for joining! We will be in touch with you soon.
