Foundations Interest Form

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Please complete this form if you'd like more information about Foundations of Emergency Medicine courses and full access to the Foundations website (www.FoundationsEM.com). *** The website password will be included in the submission confirmation message.

Name *

Preferred email address? *

Program name? *

What specialty do you represent? *

Emergency Medicine

Other:

Are you a *

Leader (faculty, fellow)

Learner (resident, PA, NP, med student)

Please indicate the level of learner *

PGY1

PGY2

PGY3

PGY4

N/A

Other:

What learner type do you anticipate using content for? (check all that apply) *

Attending Physicians

Fellows

Resident Physicians

Medical Students

Physician Assistants / Nurse Practicioners

EMS Providers

Required

Which Foundations resources are you interested in? (check all that apply)

All

Foundations I (PGY-1 core content course)

Foundations II (PGY-2/3 core content course)

Foundations III (PGY-3/4 Art of EM course)

EKG I (PGY-1/2 course)

EKG II (PGY-2/3 course)

Imaging I (PGY-1/2 course)

Frameworks (PGY-1/2 learning resource)

In-Training Exam Review Resources (all levels)

Other

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