Manuscript Mentoring Program: Mentees Question Title * 1. Name Question Title * 2. Department Anesthiology Biochemistry Biomedical Engineering Biomedical Informatics Cell Biology Dermatology Emergency Medicine Family Medicine Gynecology / Obstetrics Hematology/Medical Oncology Human Genetics Medicine Microbiology/Immunology Neurology Neurosurgery Ophthalmology Orthopedics Otolaryngology Pathology Pediatrics Pharmacology Physiology Psychiatry Radiation Oncology Radiology Rehab Medicine Surgery Urology Question Title * 3. What is your faculty rank? Associate Professor Assistant Professor Instructor Question Title * 4. Location EUH TEC Emory-main campus CHOA EUHM Grady SJH EJCH VA Other (please specify) Question Title * 5. What is your e-mail address? Question Title * 6. What is your best contact number? Question Title * 7. List some of your research interests Question Title * 8. What is your meeting style preference? Choose all that apply. In person Skype Phone Question Title * 9. What kind of paper are you writing? Basic Science Research Clinical Research Quality Improvement Medical Education Clinical Topic Review Basic Science Topic Review Meta-Analysis Technology development/transfer Conference reports/symposia Case Report Narrative Other (please specify) Question Title * 10. Do you have a journal in mind? If so, which one? Question Title * 11. Where in the process are you with your manuscript? I don't have a draft yet- just an idea I have an early draft of a manuscript I have a final version of the manuscript I am working on a revision Question Title * 12. Please describe the type of help you need to reach your goal of publishing this manuscript. Question Title * 13. Please upload a copy of your CV: PDF, DOCX, DOC file types only. Choose File Choose File No file chosen Remove File Please upload a copy of your CV: Done