FCACC WIC Pearls of Wisdom Volunteer Form

FCACC WIC Pearls of Wisdom Volunteer Form
Periodically the Chapter Office receives emails from female medical students and residents who are interested in the path to becoming a cardiologist. If you are willing to be occasionally matched for a brief phone call to answer questions about your own path, and share any recommendations or pearls you may have, please complete this form.
Name*

First NameLast Name
Email*
example@example.com
Cell Number*

Area CodePhone Number
Degrees*
e.g., MD, MBBS, MPH, PHD, MBA, etc.
Practice Type
Name of Institution or Facility*
Subspecialty*

Adult Congenital & PediatricCardio ObstetricsCardio-OncologyCritical Care CardiologyElectrophysiologyGeneral CardiologyGeriatricHeart Failure & TransplantImagingInterventionalSports CardiologyWomen's Cardiology
Number of years practicing*
City*
Should be Empty: