Medical Professional Database for North America
To more effectively perform our khidmat, connections are needed between medical professionals, and between medical professionals and mumineen. Basic demographics on medical professionals in the US and Canada is also lacking - Moula TUS has directly asked for more information, but we have lacked the data to accurately answer.

To meet these needs, SBMAA is preparing a database of all medical professionals in the United States and Canada. This database will be used for multiple purposes: (1) to provide a comprehensive professional directory accessible only by SBMAA members, (2) a second opinion service accessible by the public, and (3) a source of aggregate data to provide demographic reports to araz in Hazrat Imamiyah

We request all medical professionals in the US and Canada (only) to please fill out this form so that we may build this database. Your data will not be accessible to the public unless you opt-in to be part of the second opinion project. 
Sign in to Google to save your progress. Learn more
ITS Number *
Please enter your 8-digit ITS number. If you do not have an ITS number, please enter all 9's. Example: 99999999. 
Second Opinion Service (SOS)
The Second Opinion Service will allow mumineen to find medical professionals by specialty and geographical location, so that they may obtain a second opinion for medical diagnosis and treatment. Mumineen will search by specialty, and also optionally by city, jamaat, and country. The search results will provide only full name, professional credentials, and basic contact information (phone and/or email address). Participation in this service is completely voluntary, but open to all mumin medical professionals of all types.
Opt-In: Second Opinion Service
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Saifee Burhani Medical Association (America). Report Abuse