Annual RIG Leadership & Planning Update

Annual RIG Leadership & Planning Update
RIG Name:
Please review your RIG on the SMSNA website here.

Whether you have updates to make or no changes at all, please complete this submission form so we can confirm your information has been reviewed.
Who will be your RIG Leaders?
Faculty Anchor Name:

First NameLast NameCredentials
Faculty Anchor Email:
example@example.com
Faculty Anchor Phone:
Please enter a valid phone number.Format: (000) 000-0000.
Do you have any changes to report?
Resident Champion Name:

First NameLast NameCredentials
Resident Champion Email:
example@example.com
Resident Champion Phone:

Area CodePhone Number
Resident Champion PGY Status:
Student Name:

Prefix (i.e. Mr., Ms., etc.)First NameLast Name
Student Email:
example@example.com
Student Phone:

Area CodePhone Number
Student Anticipated Graduation Date:

MonthDayYear
Date
What is the focus of your RIG?
Do you have any feedback for the SMSNA regarding the RIG program?
Should be Empty:

Who will be your RIG Leaders?