Health Professional Involvement Form

Prefix: *


First Name: *


Last Name: *


Email: *


Preferred Gender Identity: *

Comments:



Are you an alumnus of Johns Hopkins? *


Health Profession: *

Comments:



Specialty: *


Place of Employment: *


Type of Health Professional Involvement with JUMP: Event Panelist/Guest Speaker *


Type of Health Professional Involvement with JUMP: Newsletter Interview *


Type of Health Professional Involvement with JUMP: Personal Statement Review *


Type of Health Professional Involvement with JUMP: Clinical Shadowing *


Type of Health Professional Involvement with JUMP: Patient Care Experience *


Type of Health Professional Involvement with JUMP: Research Opportunities *


Type of Health Professional Involvement with JUMP: Journal Club *
The Journal Club is a proposed JUMP student group that will organize and promote gatherings of pre-health/pre-med students and health professional/faculty/graduate researchers to discuss a scientific paper found in a research journal. Attendees ask clarifying questions, inquire about different aspects of the experimental design, critique the methods, and bring a healthy amount of skepticism (or praise) to the results.


Type of Health Professional Involvement with JUMP: Formal Mentorship Program *


Would you like to be included in our JUMP Health Professionals Mentor Directory? *
The JUMP Health Professionals Mentor Directory will be an electronic "white pages" listing of your name, profession/specialty, and contact information. It will allow JUMP Members to contact you at random for questions, advice, available opportunities, etc. This opportunity is considered informal mentorship.


Directory Listing *
Please indicate how you would like to be listed in the directory (include contact information, title and credentials).


Please briefly include any additional or background information you'd like JUMP to be aware of: *
If you prefer not to share at this time, please enter N/A.


Additional questions or comments: