Clone of Occupational Environmental Medicine Interest Form

Occupational and Environmental Medicine (OEM) is a dynamic, impactful specialty—yet it’s often misunderstood or overlooked within the broader medical community. As an ACOEM Ambassador, you can help change that.

By visiting your alma mater or affiliated university, college, or medical program, you’ll have the opportunity to:

Share stories of successful OEM physicians
Build meaningful mentor/mentee relationships
Spark interest and awareness among future medical professionals
Champion a specialty that protects and promotes worker health
Interested in joining the Ambassador Program? Email us at acoemambassadors@gmail.com—this inbox is monitored by our volunteer leaders and ACOEM staff.

Name

First NameLast Name

Email

example@example.com

Current Position

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Institution or Company Where You Are Employed

City and State you Reside in

EmailPhone CallOther

YesNo

VirtualIn-Person

YesNo

VideoWrittenParticipate in a panel discussionOther

YesNo

In-PersonVirtual

Please allow up to five business days for one of our OEM professionals to reach out and connect with you directly to answer any questions you may have.

Ambassador Interest Form

Contact Information

Mentoring or Job Shadowing?

Opportunities to Lean more about OEM

Please share any additional information or ideas you think would be beneficial to help promote OEM.