COVID-19 Information Session Sign Up Form

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Thank you for your interest in participating in our COVID-19 information session about the coronavirus pandemic. Each session will be run by two medical students and will start with a prepared presentation about COVID-19 followed by an interactive question and answer session. We anticipate each session will last about 40 minutes.

Please fill out this form and short survey if you are interested in attending a session. You will receive an email with more information about your session and a link to the Zoom meeting. The email will also contain a link to a feedback form that you can fill out after the session is over so we can continue to make these sessions as useful as possible.

Name *

Email Address *

Would you like to attend an information session? *

Yes, I am interested! Please follow up with me about the next information session.

I do not want to attend an information session but I would like to receive COVID-19 information sheets by email

Required

We will hold these presentations using the Zoom platform. Do you need more information about Zoom or assistance with using Zoom?

Yes

Clear selection

What is your preferred language?

English

Spanish

Polish

Arabic

French

Other:

Overall, how knowledgeable do you feel about COVID-19/coronavirus?

Not very

Very much

Clear selection

How knowledgeable do you feel about the following components of COVID-19?

Not at all

Average

Very

Background

Transmission/Spread

Symptoms

Prevention

Treatment

Best Practices

Clear selection

Do you have any questions that you would like us to answer (there will also be time for questions at the end of the presentation)?

Anything else you would like us to know?

Submit

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