Cleveland Dermatological Society Meeting on April 20, 2023 at Northeast Ohio Medical University (NEOMED) in Rootstown, Ohio

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We're looking forward to organizing an all day in-person CDS Meeting on Thursday, April 20, 2023 at NEOMED. Dr. Eliot Mostow is planning an amazing program. Please complete the survey by March 31st to submit your registration to attend.

Email *

Please let us know if you're planning to attend the morning session of the CDS meeting on Thursday, 4/20/2023. *

Yes, I plan to attend the morning session of the CDS meeting on 4/20/2023.

No, I cannot attend the morning session of the CDS meeting on 4/20/2023.

Required

If you would like to receive a box lunch, please let us know. *

Yes, I would like to receive a box lunch.

No, I do not want to receive a box lunch.

Required

Please enter any dietary restrictions here. Enter N/A if not applicable. *

Please let us know if you're planning to attend the afternoon session of the CDS meeting on Thursday 4/20/2023. *

Yes, I plan to attend the afternoon session of the CDS meeting on 4/20/2023.

No, I cannot attend the afternoon session of the CDS meeting on 4/20/2023.

Required

Please let us know if you're planning to attend the CDS social following the meeting on Thursday 4/20/2023. *

Yes, I plan to attend the social following the CDS meeting on 4/20/2023.

No, I cannot attend the social following CDS meeting on 4/20/2023.

Required

Please enter your last name, first name *

Please provide your current status and affiliation (i.e. medical student, resident training level, attending physician) *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms