Please use this form to submit your comments, suggestions, and concerns about all aspects of the Stillwater Medical Internal Medicine Residency Program.
 
This survey is anonymous unless you self-identify through the comments you enter. IP addresses are not recorded and you are not required to enter any personal information.

Guidelines:
 
  1. Be specific and give details on a particular situation or particular person's behavior.
  2. Please be clear, honest, and respectful.
  3. Positive comments and feedback are welcome too!
  4. Emergencies or other issues that require attention within minutes or hours should be reported to the program director or chief resident - not here.

This is not a HIPAA-compliant communication modality. Do not submit any patient-specific identification or information.

Question Title

* 1. What is your PGY level? (optional, answer not required)

Question Title

* 2. What topic are you addressing?

Question Title

* 3. Please enter your comments, concerns, or suggestions:

Question Title

* 4. If you have an idea for a solution to a problem, please enter it here. (optional)

T