2027 United Imaging Radiology Management Program Application
Complete the below application for the United Imaging Radiology Management Program. Submissions are due by October 8, 2026.
General Applicant Information
First Name
*
Last Name
*
Credentials
Email Address
*
example@example.com
Institution
*
Department
*
Current Position in Department
*
System Department Chair
*
System Department Chair Email
*
Office Address
City
State
Zip Code
Phone Number
United Imaging Radiology Management
Aspirational Role in Department within the next 5 years
*
Total Number of Radiologists in Department
*
How many Direct Reports do you have
*
Why are you interested in this program or what do you hope to gain by attending this course?
*
Acknowledgement of Support
*
I confirm that I have obtained the required institutional support for this application.
Upload Chair acknowledgement
*
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