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POLOM Interest Form
Please fill out this form if you are interested in the Physician Oral Language Observation Matrix (POLOM) rating course and/or the POLOM exam. After reviewing your responses, our team will be in touch with additional information. Thank you! ¡Muchas gracias!
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Email
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Your email
Full name (example: Ana Elena MORALES).
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Your answer
Title/role
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Your answer
Institution/organization
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Your answer
Type of institution or program where you work and envision using the POLOM. Select all that apply (if you select "other", please describe).
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Medical school
Residency or fellowship program
Hospital
Other:
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Please select what aspects of the POLOM you are interested in learning more about. Select all that apply
(if you select "other", please describe).
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POLOM testing/exam for medical students
POLOM testing/exam for other candidates
Becoming a Certified POLOM Rater
Other:
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How did you learn about the POLOM?
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Your answer
Feel free to include any comments or questions.
Your answer
A copy of your responses will be emailed to the address you provided.
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