Skip survey header

Call for Annual Assembly Faculty

Have you ever wanted to present at the Annual Assembly but haven’t had the opportunity? Do you have expertise on a topic? Are there other presenters that you would recommend? We know that our members have a wealth of knowledge and experience to share with each other – and we’re hoping you’ll help us tap into that expertise.

In addition to potentially being faculty for the Annual Assembly, the Academy might also contact you to gauge your interest in being faculty for other educational activities that Academy is developing. 
4. What is your primary practice setting? *This question is required.
5. Would you be willing to work with potential speaker/individuals you do not know? *This question is required.
6. What do you consider to be your clinical areas of expertise (check all that apply)?
7. What do you consider to be your non-clinical areas of expertise (check all that apply)?
8. Are you interested in recommending another potential speaker? *This question is required.
If yes, please provide the a) full name, b) organization/location and c) area of expertise for each potential speaker you would recommend. If possible, please provide comments indicating why you would recommend this individual:
Space Cell Full NameOrganizationArea of ExpertiseComments
Recommendation:
Recommendation:
Recommendation:
0%