NYAM Workshop

In completing this extended additional survey, you are also registering for access to the workshop interactive website, which will provide you with instructional and communicational resources which constitute an essential feature of the program. You have already provided some of the information asked for here in the course of completing the first registration page and we apologize for making you repeat it. The full website will not become available until we are closer to the workshop and you will receive an email message advising you when you can start to access it.

Fields marked with * are mandatory

Account information

Personal information

 Home   Work  

Institutional information

 Attending Physician
 Biotech Professional (specify under other)
 Nurse Practitioner
 Pharmacist (specify under other)
 Physical Therapist
 Physician Assistant
 Researcher (specify under other)
 Resident or Fellow (specify under other)
 Student (specify under other)
 Other Allied Health Professional (specify under other)

Interest profile

 Yes    No   

Graduation information

Degree information

Who is sponsoring your participation in the workshop?

Which is the track you are subscribing for?

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