ADURS Managed Care Residency Listserv

Please fill out the following form if your residency program would like to be notified about the annual ADURS Symposium Poster Session Managed Care Resident Scholarship opportunity. Notifications will be sent out in the fall each year. All programs will be verified with the ASHP website.

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* 1. Residency Program Information

Residency Program Name/Company *

City

State/Province

Country (optional)

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* 2. Please choose one.

New listserv member

Updating contact information

Remove program from listserv

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* 3. Residency Director Contact Information.

First Name *

Last Name *

Designation(s), if applicable (e.g. PharmD, PhD, BCPS, etc)

Work Email Address *

Work Phone Number *

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* 4. Director of Pharmacy Contact Information (if different from Residency Director)

First Name

Last Name

Designation(s), if applicable

Work Email Address

Work Phone Number

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* 5. Program Contact (optional - if different from above)

First Name

Last Name

Designation(s), if applicable

Work Email Address

Work Phone Number