We look forward to you joining us at the New Jersey Pediatric Psychiatry Collaborative (NJPPC) Northern Regional Dinner and CME Presentation on "ADHD & Anxiety: Making Sense of Overlapping Symptoms in the Pediatric Setting" with Dr. Alex Soloway. The event will be held at Maggiano's Little Italy (70 Riverside Square Mall, Hackensack, NJ 07601) on May 20, 2026, from 5:30 pm to 8 pm (program begins at 6 pm). Free Parking is available. Additional details to follow.

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*1.Demographics(Required.)

First Name

Last Name

Credentials (MD, DO, APN, PA, etc.)

Practice/Organization Name

Practice County

Email Address 

Phone Number

*2.NPI Number (if not applicable, please write "NA")(Required.)

*3.Please indicate if you are an attending or a medical resident at your practice:(Required.)

Attending

Resident

Other (please specify your position)

*4.Are you a member of the New Jersey Pediatric Psychiatry Collaborative (NJPPC)?

Not a member? Find a link to the registration form at the end of the survey.(Required.)

I am a NJPPC member

I am not a NJPPC member 

Unsure if I am a NJPCC

5.What questions do you have for our presenter on the topic of ADHD & anxiety comorbidities?

6.Do you have any questions for our Physician Champion on how they integrate mental health care and/or work with the NJPPC in their practice?

*7.Are you a member of the New Jersey Chapter of the American Academy of Pediatrics? (Please note, this is a separate membership from the national American Academy of Pediatrics)(Required.)

I am an NJAAP member

I am not an NJAAP member

Unsure if I am an NJAAP

*8.Do you require a Kosher meal at this dinner event? (If you indicate "yes," please check your email for more information as the event gets closer.")(Required.)

Yes

No

9.Do you require any special accommodations or is there anything else you would like us to know (e.g., food allergies)?

Not a NJPPC member? Register here! https://www.nj-ppc.org/registration/