Sign in to Google to save your progress. Learn more
What's Your Family Medicine Story?
For the Department of Family Medicine and Community Health’s 50th Anniversary, we want to hear your most memorable story about family medicine! Perhaps it’s the wildest night on call as a resident, a special connection with a patient, or the feeling you had when your first study was published.

Fill out the form below, and your story could be featured on our website or social media channels!
Who you are
Your name
Your email address
Your affiliation with DFMCH (check all that apply)
Your family medicine story (no word count restriction)
You may type your story here, or email it to fmchcomm@umn.edu.
Send us your photos!
If you have photos related to your story or of your time in family medicine, please email them to us at fmchcomm@umn.edu.
Permissions
By submitting this image and text, I hereby grant to the University of Minnesota (UMN) the irrevocable and non-exclusive right to use, reproduce, distribute and broadcast my image, including my name, likeness and affiliation with the university.

I understand that I will have not have an opportunity to approve use of the material prior to the use, reproduction, distribution or broadcasting thereof. Furthermore, I agree that UMN shall have the right to edit or modify the material to accommodate space and content restrictions.

By clicking “Submit,” I confirm my understanding of the nature and effect of this consent, release and declaration and I agree to be bound by it.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Minnesota Twin Cities. Report Abuse