Application Form
Role of OEM Physicians in Educating Health Professionals
Name
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First Name
Last Name
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Email
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example@example.com
What topic(s) would you be interested in writing?
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Cardiovascular
Orthopedics (e.g., spine)
Seizure
Other
If other, please specify:
Please include a brief statement on why you wish to be considered a writer for one of the chapters for the public safety medicine guidance.
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Do you have any conflicts of interest?
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Yes
No
If yes, please disclose your conflicts of interest.
Upload a current CV.
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