UW Radiology Medical Student Interest Form
This form is intended to provide us with some basic information about you. This will give us the best chance to match you up with a mentor who can address your specific interests. You are welcome to use the text field at the bottom of the survey to communicate any additional information that you feel would be useful for us to know.

While we may not be able to pair you with a mentor that matches each and every one of your preferences, we will try to match as many of them as we can. Please feel free to contact me by email if you have questions.

-Jason W. Stephenson, MD (jstephenson@uwhealth.org)

Name:
Your answer
Email Address:
Your answer
Please indicate your year in medical school:
Please indicate any areas of radiology that are of particular interest to you. If you are unsure or unfamiliar with the different subspecialty areas, feel free to choose "Undecided" and move on to the next question.
Check all that apply
Please indicate any imaging modalities that are of particular interest to you. If you are unsure or unfamiliar with the different imaging modalities, feel free to choose "Undecided" and move on to the next question.
Check all that apply
Are you interested in image guided procedures?
Are you interested in doing a radiology-related research project?
Please feel free to share any additional information that you feel would help us match you with an ideal radiology mentor.
Your answer
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