PRE-MED SOLUTIONS PARTICIPANT INFO
Name
*
First Name
Last Name
Email
*
example@example.com
LinkedIn URL
*
What year(s) did you participate as a mentee in the Pre-Med Solutions program?
*
Please Select
Prior to spring 2020
Spring 2020
Spring 2021
Spring 2022
What is your current status ?
*
Attending physician
Fellow
Resident
Current medical student
Recently Admitted Medical Student
Where did you go to medical school?
*
What year did you graduate from medical school?
*
What is your specialty?
*
Where did you do your residency?
*
Where did you do your fellowship?
Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional professional or Image from your time in the program (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you willing to continue as a mentor for Pre-Med Solutions?
Yes
No
What specialty is your fellowship in?
*
Where are you doing your fellowship?
*
Where did you do your residency?
*
Where did you go to medical school?
*
What year did you graduate from medical school?
*
Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional professional or Image from your time in the program (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you willing to continue as a mentor for Pre-Med Solutions?
Yes
No
What specialty is your residency in?
*
Where are you doing your residency?
*
Where did you go to medical school?
*
What year did you graduate from medical school?
*
Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional professional or Image from your time in the program (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you willing to continue as a mentor for Pre-Med Solutions?
Yes
No
Where are you in medical school?
*
What year do you anticipate graduating from medical school?
*
Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional professional or Image from your time in the program (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you willing to continue as a mentor for Pre-Med Solutions?
Yes
No
RECENTLY ADMITTED MEDICAL STUDENT
List the medical schools where you got accepted this cycle
What medical school will you be attending in the fall?
Professional Headshot
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Additional professional or Image from your time in the program (Optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Are you willing to continue as a mentor for Pre-Med Solutions?
Yes
No
What is life like now that you've experienced Pre-Med Solutions?
1. What were you looking for prior to starting Pre-Med Solutions? 2. What results have you gotten from our program?3. Why would you recommend this to someone who might be on the fence?
Submit
Should be Empty: