IM Grand Rounds Presentation Viewing Attestation

Used to collect names of the KUMC Internal Medicine Faculty and Staff who are requesting departmental dashboard credit for IM Grand Rounds presentation viewable on our Panopto Video Server (opens in a new window).

When you submit this form, the owner will see your name and email address.

All fields marked with * are required and must be filled.

Name*

First NameLast Name

KUMC Email*

example@kumc.edu

Name of Video*

Type in the title of the KUMC IM Grand Rounds video presentation as it appears on the Panopto Video Server.

Enter the date of the Grand Rounds video presentation*

The date of the recording is at the beginning of the video title.

By submitting this form, I attest that I have viewed the entire IM Grand Rounds video presentation*