Pharmacy Kannected Mentor Program
Registration is open until October 26. Pairing will be emailed on November 6. Contact Shelby Brown (shelby.brown@lmh.org) or Jersey Lynn (jerseynacole13@ku.edu) with questions.
Personal Information
Name
*
First Name
Last Name
Phone Number
E-mail
*
example@example.com
Role
*
Student
Resident or New Practitioner
Pharmacist
Current Job Title and Company/Institution
*
Matching Questions
Please provide information to help us match you with a mentor/mentee.
Where do you currently live?
Where is your hometown?
What are your hobbies outside of pharmacy?
Students: What is your desired practice setting and/or speciality (ex. community pharmacy, critical care, ambulatory care, etc.)? Are you planning to pursue a PGY-1 and/or PGY-2 residency?
Pharmacists and Residents/New Practitioners: What is your current practice setting and/or specialty? Did you complete a PGY-1 and/or PGY-2 residency?
What professional groups or organizations are you involved in?
Why do you want to participate in the Pharmacy Kannected Mentor Program?
Please feel free to add any additional information you think we should know:
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