Reviewer Mentorship Program Signup Form
Thank you for your interest in the Reviewer Mentorship Program as a part of the Machine Learning for Health Symposium 2022.

Please carefully review the expectations and guidelines for the program described at https://ml4health.github.io/2022/reviewer_mentorship.html.

To confirm your participation and to help us understand your background, please fill out the following form. 

NOTE: Please ONLY fill this form if you have NOT filled the reviewer invitation questionnaire.

The deadline to confirm participation is August 20, 2022.
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First name *
Last name *
Institutional email *
Institution *
Title
In what role would you like to participate? *
If participating as a mentor, how many mentees would you be willing to work with?
Clear selection
What is your training status? *
How many papers have you reviewed in the past? *
If you have limited review experience (i.e. you've reviewed 0-2 papers in the past), please provide links to research experience, such as, google scholar and arxiv. 

(This information will give us a better understanding of your research experience which we use in our algorithm to best match you with a mentor/mentee)
Areas of Expertise
Please indicate your interest in reviewing papers on these topics. We use this information to help match papers to reviewers, and reviewer-mentees with reviewer-mentors.
Preferred data modalities (choose as many as you want) *
Required
Preferred subject areas (choose as many as you want) *
Required
Conflicts of Interest
Please list potential conflicts of interest. We use this information when assigning reviews. This includes past advisors and students, people with the same affiliation, and any recent (~3 years) coauthors and collaborators.
List email domains of institutional conflicts with over the past 3 years. For example: “@mit.edu, @umich.edu" (without quotation marks) *
List personal conflicts of interests (past advisors/students, and coauthors/collaborators of the past 3 years). Separate with commas; no need to include people already covered by the institutional conflicts. For example: “Monica Agrawal (magrawal@mit.edu), Shengpu Tang (tangsp@umich.edu)” (without quotation marks) *
Anything else you'd like to tell us?
I understand that by submitting this application, I commit to writing and submitting my reviews within the review period (Sep 5 - Oct 14), and to fulfilling other responsibilities described at https://ml4health.github.io/2022/reviewer_mentorship.html *
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