Appropriate Use Criteria (AUC) Participation Interest Form
Thank you for your interest in participating in an AAOS Appropriate Use Criteria work group. Please provide your information below. We will contact you as upcoming panel participation opportunities become available.
Name
*
First Name
Last Name
Credentials (e.g. MD, PhD, MA, etc.)
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Email Address
*
Assistant's Email Address
Please List your Primary Specialty:
*
Adult Hip
Adult Knee
Adult Spine
Pediatric Spine
Foot and Ankle
Hand
Shoulder and Elbow
Pediatric Orthopaedics
Trauma
Sports Medicine
Arthroscopy
Rehab/Prosthetics and Orthotics
Ortho/Oncology
Disability Legal Orthopaedics
Total Joint
Other
If you selected "Other" please specify below
Please list your work setting
*
Academic Practice
Clinical Hospital
Military
Non Military Government or Public
Pre-paid HMO
Private Group or Practice
Other
If you selected "Other" please specify below
Preferred Orthopaedic Topics:
*
THANK YOU FOR YOUR INTEREST
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