Registration for the 2023 Women in Medicine and Science Symposium Survey

1.Name(Required.)

First Name:

Last Name:

2.Degree(s):(Required.)

3.Email address (preferably MGB email):(Required.)

4.MGB network username:(Required.)

5.Gender:(Required.)

6.Current HMS rank/Hospital title:(Required.)

7.Primary institution:(Required.)

Brigham and Women's Hospital

Massachusetts General Hospital

Other institution

8.Do you plan to attend the optional networking session at 5pm in the Hale Atrium (directly outside the main event)?(Required.)

Yes

No

Not sure yet