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Country
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France (French)
Germany (German)
Italy (Italian)
Spain (Spanish)
United Kingdom (English)
United States (English)
Which best describes your occupation / type of involvement in the Healthcare industry?
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Select
MD or DO
Other
Which of the following best categorizes your current degree attainment status?
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Physician in Training/Residency
Medical Doctor
How would you classify your primary practice setting?
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Private Practice
Group Practice
Other
General Hospital
Teaching Hospital
Ambulatory Care Center
Long Term Care/Nursing Home
What is your primary specialty?
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Select
Addiction Medicine
Allergy & Immunology
Anesthesiology
Cardiology
Interventional Cardiology
Critical Care Medicine
Dermatology
Endocrinology, Diabetes & Metabolism
Emergency Medicine
Family Practice/General Practice
Gastroenterology
Genetics
Geriatrics
Hematology
Hepatology
Hospitalist
Infectious Disease
Internal Medicine
Nephrology
Neurology
Obstetrics & Gynecology
Oncology
Ophthalmology
Orthopedics/Orthopedic Surgery
Otolaryngology/ENT
Pain Medicine
Pathology
Pediatrics
Physical Medicine & Rehabilitation
Plastic/Cosmetic Surgery
Preventive Medicine
Psychiatry
Pulmonology
Radiology
Interventional Radiology
Rheumatology
Surgery
Urology
Which of these Allergy & Immunology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Allergy
Allergy & Immunology/Diagnostic Lab
Allergy & Immunology
Immunology
Pediatric Allergy
Pediatric Immunology
None of the above
Other
Which of these Anesthesiology sub-specialties are you involved with? Please select all that apply.
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Critical Care Anesthetics
Pain Management Anesthetics
None of the above
Hospice and Palliative Medicine
Which of these Cardiology sub-specialties are you involved with? Please select all that apply.
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IM - Cardiac Electrophysiology
Interventional Cardiology
Nuclear Cardiology
None of the above
Which of these Dermatology sub-specialties are you involved with? Please select all that apply.
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Dermatopathology
Pediatric Dermatology
None of the above
Cosmetic Dermatology
Which of these Emergency Medicine sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Emergency Medical Toxicology
Emergency/Sports Medicine
Hospitalist
Pediatric Emergency Medicine
Undersea and Hyperbaric Medicine
Urgent Care Medicine
None of the above
Which of these Endocrinology, Diabetes & Metabolism sub-specialties are you involved with? Please select all that apply.
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Diabetes
Reproductive Endocrinology
None of the above
Which of these Family Practice / General Practice sub-specialties are you involved with? Please select all that apply.
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Adolescent Medicine (Family Practice)
Geriatrics
Sleep Medicine
None of the above
Which of these Gastroenterology sub-specialties are you involved with? Please select all that apply.
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None of the above
Hepatology
Which of these Genetics sub-specialties are you involved with? Please select all that apply.
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Clinical Biochemical Genetics
Clinical Cytogenetics
Clinical Genetics
Clinical Molecular Genetics
Medical Genetics
Metabolic Genetics
Molecular Genetic Pathology
Pediatric Genetics
None of the above
Which of these Geriatrics sub-specialties are you involved with? Please select all that apply.
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Family Practice-Geriatric Med
Geriatric Psychiatry
Hospitalist
Internal Medicine - Geriatrics
Other
None of the above
Long-term Care Geriatrics
Which of these Hematology sub-specialties are you involved with? Please select all that apply.
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Hematology/Oncology
Pediatric Hematology
None of the above
Which of these Infectious Diseases sub-specialties are you involved with? Please select all that apply.
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HIV/AIDs Specialist
None of the above
Which of these Internal Medicine sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Adolescent Medicine
Critical Care Medicine
Gastroenterology
Hematology
Hepatology
Hospitalist
IM - Diagnostic Lab Immunology
Infectious Diseases
Internal Medicine - Pediatrics
Internal Medicine - Sports Med
Nephrology
Nutrition
Pulmonary Critical Care Med.
Pulmonary Disease
Rheumatology
Vascular Medicine
None of the above
Cardiology
Endocrinology, Diabetes & Metabolism
HIV/AIDS Specialist
Medical Oncology
Sleep Medicine
Which of these Neurology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Child Neurology
Clinical Neurophysiology
Neurodevelopmental Disabilities/Movement Disorders
Vascular Neurology
Neurological Surgery
Pediatric Neurological Surgery
None of the above
Brain Injury Medicine
Epilepsy
Neuromuscular Medicine
Pain Medicine
Sleep Medicine
Which of these Obstetrics & Gynecology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Gynecology
Maternal & Fetal Medicine
Reproductive Endocrinology
Surgery
Gynecologic Oncology
None of the above
What type of oncology do you specialize in? Please select all that apply.
This field is mandatory
Clinical Oncology
Gynecological Oncology
Hematology/Oncology
Medical Oncology
Orthopedic Musculo Oncology
Pediatric Hematology Oncology
Radiation Oncology
Surgical Oncology
None of the above
Which of these Ophthalmology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Pediatric Opthalmology
Retinal Specialists
None of the above
Glaucoma Specialist
What type of orthopedics/Orthopedic Surgery do you specialize in? Please select all that apply.
This field is mandatory
Hand Surgery
Orthopedic Surgery of the Spine
Adult Recon Surgery
Orthopedic Pediatric Surgery
Orthopedic Sports Medicine
Orthopedic Surgery - Trauma
Orthopedics (Foot & ankle)
None of the above
Which of these Otolaryngology / ENT sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Otology - Neurotology
Pediatric Otolaryngology
Plastic Surgery - Head & Neck
None of the above
Sleep Medicine
Which of these Pathology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Anatomic Pathology
Anatomic/Clinical
Blood Banking
Chemical
Clinical Pathology
Cytopathology
Dermatopathology
Forensic Pathology
Hematological Pathology
Medical Microbiology
Molecular Genetic Pathology
Neuropathology
Pediatric Pathology
Selective Pathology
None of the above
Which of these Pediatrics sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Adolescent Medicine
Critical Care
Developmental - Behavioral
Internal Medicine
Neonatal-Perinatal Medicine
Neurodevelopmental Disabilities
Allergy
Anesthesiology
Emergency Medicine
Endocrinology
ENT
Gastroenterology
Hematology
Neuromuscular Medicine
Hospitalist
Pain Medicine
Infectious Diseases
Medical Toxicology
Nephrology
Neurology
Psychiatry
Pulmonology
Rehab Medicine
Rheumatology
Sports Medicine
Diag Lab Immunology
None of the above
Which of these Physical Medicine & Rehabilitation sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Pediatric Rehabilitation Medicine
Spinal Cord Injury
Sports Medicine
None of the above
Which of these Plastic / Cosmetic Surgery sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Bariatric Surgery
Craniofacial Surgery
Facial Plastic Surgery
Laproscopic Surgery
Reconstructive Surgery
None of the above
Which of these Preventive Medicine sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Aerospace Medicine
Occupational Medicine
Preventive Medical Toxicology
Public Health/General Prevent Med
Undersea Medicine
None of the above
Which of these Pulmonology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Hospitalist
Pulmonary Critical Care Med.
None of the above
Pulmonary Critical Care Medicine/Intensivist
Sleep Medicine
Which of these Radiology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Abdominal Radiology
Cardiothoracic Radiology
Diagnostic Radiology
Musculoskeletal Radiology
Neuroradiology
Nuclear Radiology
Pediatric Radiology
Radiological Physics
Vascular/ Interventional Radiology
None of the above
Which of these Rheumatology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Pediatric Rheumatology
None of the above
What type of surgery do you specialize in? Please select all that apply.
This field is mandatory
Abdominal Surgery
Bariatric Surgery
Colon & Rectal Surgery
Cosmetic Surgery
Critical Care Surgery
Dermatologic Surgery
Endovascular Surgical Neuroradiology
General Surgery
Gynecological Surgery
Hand Surgery
Head & Neck Surgery
Laproscopic Surgery
Oral And Maxillofacial Surgery
Pediatric Cardiothoracic Surgery
Pediatric Surgery
Proctolgy
Reconstructive Surgery
Thoracic Surgery
Transplant Surgery
Cardiothoracic Surgery
Traumatic Surgery
Orthopedic Surgery
Vascular Surgery
Plastic Surgery
Cardiovascular Surgery
Neurological Surgery
Other
None of the above
Which of these Urology sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Pediatric Urology
Proctology
Urological Surgery
None of the above
Female Pelvic Medicine and Reconstructive Surgery
Which of these Psychiatry sub-specialties are you involved with? Please select all that apply.
This field is mandatory
Addiction Psychiatry
Child Psychiatry
Forensic Psychiatry
Neuropsychiatry
Pain Medicine (Psychiatry)
Pediatric Psychiatry
Psychoanalysis
Psychosomatic Medicine
None of the above
Epilepsy
Neuromuscular Medicine
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Date of birth
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Email address
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City
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