Tell us about yourself

CCIM is fast becoming a vibrant community. We are looking for passionate medical professionals to be profiled on the CCIM website to show the diversity of our community and highlight some of the great work being done both inside and outside of medicine.

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Email

Question Title

* 4. Describe where you are currently in your medical/health career

Question Title

* 5. Tell us a little about yourself

Question Title

* 6. What was your first paying job?

Question Title

* 7. When did you decide that medicine/health was the career path for you?

Question Title

* 8. What is the best piece of career advice you have ever received?

Question Title

* 9. If you were not working as a medical/health professional what alternate career would you like to have?

Question Title

* 10. What is your favourite quote?

Question Title

* 11. What is something few people would know about you?

Question Title

* 12. Are there any links you would like included with your profile? (website, social media etc)

Question Title

* 13. Upload a suitable photo of your self that can accompany your responses (this will be featured on the CCIM website and social media channels)

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

T