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Request to convene the Resident/Fellow Forum
To request a convening of our institution's Resident/Fellow Forum, please submit the form below.
Questions about the Resident/Fellow Forum can be sent to
pclark5@uic.edu
.
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* Indicates required question
Your Full Name
*
Your answer
Your Program
*
Your answer
Your UIC Email Address
*
Your answer
Please list up to 5 preferred dates and times for the forum.
*
Due to the limited availability of meeting spaces in the near term, please do not list any dates less than 1 month away.
Your answer
Please list the topics and concerns that you wish to discuss at the forum.
*
Your answer will allow our team to make the appropriate UIH/COM resources and personnel available to address any issues.
Your answer
Do the residents and fellows wish
to conduct a portion of the forum without the DIO, faculty members, or other UIH/COM administrators present?
*
Yes
No
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