24-25 Resident Travel Funding Request

24-25 Resident Travel Funding Request

Please provide details about your travel request and upload the agenda for the conference. It is important that you do NOT book any travel until you have discussed booking details with your program coordinator.
Name: *

First NameLast Name
Name of Conference: *
Conference Location:
Rotation during time of conference
First Travel Date:*

MonthDayYear
Return Date: *

MonthDayYear
Have you previously attended a conference within the current academic year? *

YesNo
If yes, did IM residency fund your travel? *

YesNo
Travel Details

Once you have submitted this jotform, you will be contacted by your program coordinator within one business day to answer any questions you may have. If you are not contacted within one business day, please reach out to Kristin Sparks at Kristin.Sparks@uky.edu
Hotel Required?*

YesNo
Will you be flying or driving to this conference?*

FlyingDriving
Scholarly Activity

Please provide the details of your scholarly activity below. It is required that you enter your scholarly activity in MedHub before travel.
Scholarly Activity Type:*

AbstractClinical VignetteOral PresentationPoster PresentationResearch Presentation
Name of presentation/abstract/research:*
Date/time of presentation*
Please add any additional information you consider relevant to your travel.
Coverage

Please be in close communication with the inpatient Chief and follow usual protocol for inpatient request. You are responsible for finding your own coverage
Please upload the agenda (at a glance or full agenda is fine).

Upload a File

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