Country/Region
*
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic
Cook Islands
Costa Rica
Côte d´Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czechia
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Lao People´s Democratic Republic of
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Réunion
Romania
Russian Federation
Rwanda
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwitch Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
*
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
First Name
*
Last Name
*
Email address (needed to receive special offer)
*
Stage of Profession
*
Case Manager
Clinician/Physician/Practitioner
Education (Preceptor or Educator)
Executive/Executive Director
Faculty
Fellow
Frontline Supervisor
Informaticist
IT
Librarian
Marketing
Nurse Management (Charge Nurse, Lead Nurse, etc)
Nurse/RN
Other
Patient Care/Quality/Compliance/Safety
Pharmacist
Pricing and Reimbursement
Resident/Trainee
Sales
Staff Development/HR
Student
Support Worker
Stage of Profession
*
PGY-1 Resident
PGY-2 Resident
PGY-3 Resident
PGY-4 Resident
PGY-5/6/7+ Resident
Fellow
Attending physician
Other
Other role:
*
Medical Specialty
*
Allergy and Immunology
Anatomic/Clinical Pathology
Anesthesiology
Cardiovascular Disease
Child and Adolescent Psychiatry
Clinical Cardiac Electrophysiology
Colon and rectal surgery
Critical Care Medicine
Dermatology
Emergency Medicine
Endocrinology, Diabetes, and Metabolism
Family Medicine/General Practice
Gastroenterology
General Surgery
Geriatric Medicine
Hand Surgery
Hematology and Oncology
Hospice and Palliative Medicine
Infectious Disease
Internal Medicine
Internal Medicine/Pediatrics
Interventional Cardiology
Neonatal-Perinatal Medicine
Nephrology
Neurological Surgery
Neurology
Neuroradiology
Obstetrics and Gynecology
Ophthalmology
Orthopedic Surgery
Otolaryngology
Pain Medicine and Pain Management
Pediatric Anesthesiology (Anesthesiology)
Pediatric Cardiology
Pediatric Critical Care Medicine
Pediatric Hematology/Oncology
Pediatric Surgery
Pediatrics
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry
Pulmonary Disease
Radiation Oncology
Radiology and Diagnostic Radiology
Rheumatology
Sports Medicine
Sports Medicine (Orthopedic Surgery)
Thoracic Surgery
Transitional Year
Urology
Vascular and Interventional Radiology
Vascular Surgery
Other
Other Specialty:
*
Organization type
*
Academic (Medical, Pharmacy or Nursing College/University)
Government (DoD, Federal, State, etc.)
Non-Profit (Association, Foundation, etc)
Payer (Health Plans, Benefits Management, Care Organization, PBM, TPA, etc.)
Pharmaceutical - Manufacturer/Distributor
Pharmaceutical - Retail Pharmacy
Private Practice
Professional Services - Coding/Medical Transcription Service
Professional Services - Consulting
Professional Services - Legal
Provider - Ambulatory/Out-Patient Facility
Provider - Healthcare Network
Provider - Home Health Care/Agency
Provider - Hospital
Provider - Human Services
Provider - Long Term Care (Nursing Home, Skilled Nursing Facility, Rehabilitation Center, etc.)
Provider - Medical Group Practice
Technology (HIT, EMR, EHR, etc.)
Organization type
*
Academic
Corporate
Government
Medical/Health
Other
Societies/Associations
Name of your residency program?
*
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