PAFP Student Registration for FMX

Join the AAFP Family Medicine Experience (FMX), the largest annual meeting of family physicians from across the country! The Pennsylvania Academy of Family Physicians has arranged for a special track of FMX programming to be offered free to medical students. Below are the events included in this track, and you’re invited.. Please check any you plan to attend.

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* 1. Please enter your first & last name:

First Name:

Last Name:

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* 2. Select your Medical School from drop-down list here:

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* 3. AAFP Member ID#

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* 4. Preferred Email Address

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* 5. Mailing Address

Address:

Address line 2:

City:

State:

Zip:

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* 6. Please provide an emergency contact name and phone contact:

Emergency Contact Name:

Emergency Contact Phone:

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* 7. Please check the AAFP FMX special events you plan to attend below:
Registered students are welcome to attend any of the CME sessions listed on our AAFPFMX Student Schedule

Tuesday 6-8pm PAFP Reception, Mangiano's

Wednesday 3 - 4:30pm Main Stage Event, Michael Eisner, Former Disney CEO

Wednesday 5 - 7pm Networking reception & "Plotting your course to FM" Panel, The Field House

Thursday 7:45am - Noon* Volunteer to serve as a patient actor for the workshop, “Sideline Management Assessment Response Techniques”
*Serving as a patient actor is the only way to attend this workshop free of charge, and you must be available for its entirety.

Thursday 3:15-4:45pm Main Stage Event, Lily Peng and Punit Soni

Thursday 6 - 7:30 Member Interest Group Reception

Friday 8:30 - 10am Main Stage Event, Frank J. Domino, MD

Friday 6 - 10pm FMX Celebration Xfinity Live! (1 comp ticket)

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* 8. Please indicate your preferences below should you wish to opt-out of sharing your contact information:

I do not want to share my mailing address with exhibitors in pre- and post- conference mailing lists;

I do not want to include my mailing address and email my virtual business card that is shared only with exhibitors I visit;

I do not want my name and city/state listed on the FMX attendee list.

The AAFP may take photographs and/or record audio and video at this event. By attending, you consent to the use of photographs, audio, and video recording of you by the AAFP and its designees in AAFP communications and promotions, or for any other lawful purpose.

Question Title

* 1. Please enter your first & last name:

Question Title

* 2. Select your Medical School from drop-down list here:

Question Title

* 3. AAFP Member ID#

Question Title

* 4. Preferred Email Address

Question Title

* 5. Mailing Address

Question Title

* 6. Please provide an emergency contact name and phone contact:

Question Title

* 7. Please check the AAFP FMX special events you plan to attend below:Registered students are welcome to attend any of the CME sessions listed on our AAFPFMX Student Schedule

Question Title

* 8. Please indicate your preferences below should you wish to opt-out of sharing your contact information:

* 7. Please check the AAFP FMX special events you plan to attend below:
Registered students are welcome to attend any of the CME sessions listed on our AAFPFMX Student Schedule