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CAPturing Interests Sign-up
Demographic Information
Please complete the questions below.
*
1.
Please enter your name.
(Required.)
First Name
Last Name
Institution
Email
State/ Province
Country
List up to three area(s) of interest specific to child mental health:
*
2.
What best describes your current training or career level?
(Required.)
Medical Student
General Psychiatry Resident
Child and Adolescent Psychiatry Fellow
Combined Child/Adolescent and Adult Psychiatry Residency
Triple Board Resident
Post Pediatric Resident
Mid-career
Advanced Career
Other (please specify career role)
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3.
Are you an AACAP member? [Your status will be confirmed. If you are NOT currently a member and you are eligible to join AACAP, learn about the membership process
here
.]
(Required.)
Yes
No
*
4.
Please indicate your gender.
(Required.)
Female
Male
Non-binary