FoEM Leadership Interest Form (23-25)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Foundations of Emergency Medicine (FoEM) periodically has leadership positions or curricular development and process improvement projects that would benefit from diverse perspectives with varying levels of engagement. If you are interested in being contacted with opportunities as projects arise, please complete the form below.

Email *

Full Name *

Affiliated Institution *

Preferred Email (if different from above):

*Please add admin@foundationsem.com to your contacts to prevent blocked communications from our team.

Level of Training *

Senior Faculty (6+ years)

Junior Faculty (1-5 years)

Fellow

PGY-4 Resident

PGY-3 Resident

PGY-2 Resident

PGY-1 Resident

PA/NP

Medical Student

Program Coordinator/Admin

Other:

Potential Level of Involvement *

Please select the highest level of involvement you might be able to commit to.

HIGH- major position, weekly tasks

MEDIUM- minor position, monthly tasks

LOW- limited project-based work

Do you have any specialized training or expertise that may serve our team?

Examples include: fellowship training of any kind, advanced degrees, other specialized training, prior career experience, artist/graphic design, social media guru, medicolegal insight, data analytics/informatics, website design, etc.

Is there a particular team, project, or type of involvement that interests you?

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Foundations of Emergency Medicine. Report Abuse

Forms