AMIGO is a joint effort of the ACR and CARRA to promote the career development of pediatric rheumatologists in the early stages of their careers through mentoring. This intake questionnaire is designed to help AMIGO match you with a mentor at a different institution, based upon complementary needs and expertise, while also considering common interests.

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* 1. Contact Information:

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* 2. Gender
The ACR does not discriminate based on age, ethnicity, or gender identity or expression.

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* 3. In which State, Providence, or Territory is your current primary work address?

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* 4. With which of the following fellowship programs have you been associated?
*Please include the program in which you trained and any other programs in which you have worked. In order to ensure a fresh perspective, we will NOT match you with a mentor from these institutions. 

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* 5. What is your academic rank as of July 1, 2021?

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* 6. What type of fellowship training did you receive?

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* 7. What type of fellowship training are you currently enrolled?

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* 8. In which year did you graduate from fellowship? If you are currently still in fellowship, please list N/A.

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* 9. In addition to your MD/DO degree, have you done any advanced graduate or postgraduate training, such as a PhD or Masters degree?

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* 10. In what year did you complete your additional degree?
*If you are currently enrolled in a program, please provide the year of anticipated completion.

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* 11. What was your degree and in which field of study did you complete it?

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* 12. What degree will you obtain and in which field of study will it be?

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* 13. What is your primary anticipated career path?

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