Join your FPA Network colleagues on Fairview.org!

Please complete this form to add or update your provider bio on Fairview.org. Please contact Lisa Rosemeyer with any questions or call 952-914-1843. Scroll down to get started. Thank you!

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Example: Provider Bio Page

<span style="font-size: 10pt; color: #666699;"><em>Example: <a href="https://www.fairview.org/providers/HalversonPhilip-1962448743" rel="nofollow" target="_blank">Provider Bio Page</a></em></span>
Provider information

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* 1. Provider information

Note: FPA Network does not share provider emails or post them on bios. Emails are a requirement for network communication.
Practice/Clinic information

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* 2. Practice/Clinic information

Other locations where you see patients (city or address)

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* 3. Other locations where you see patients (city or address)

Hospital Privileges (check all that apply)

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* 4. Hospital Privileges (check all that apply)

Languages other than English (check all that apply)

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* 5. Languages other than English (check all that apply)

Site of Medical School

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* 6. Site of Medical School

Site of Residency

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* 7. Site of Residency

Site of Fellowship (and area of specialty)

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* 8. Site of Fellowship (and area of specialty)

Site of Masters (and degree earned)

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* 9. Site of Masters (and degree earned)

Site of Ph.D. (and degree earned)

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* 10. Site of Ph.D. (and degree earned)

Other Education

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* 11. Other Education

Philosophy of Care (one to two sentences on how the provider views his/her practice)

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* 12. Philosophy of Care (one to two sentences on how the provider views his/her practice)

Clinical/medical Interests (e.g., prenatal care, diabetes, sports injuries)

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* 13. Clinical/medical Interests (e.g., prenatal care, diabetes, sports injuries)

Research Interests

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* 14. Research Interests

Honors (awarded in the past 5 years)

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* 15. Honors (awarded in the past 5 years)

Publications (published in the past 5 years)

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* 16. Publications (published in the past 5 years)

Other names you go by (maiden) or ways people incorrectly spell your name (for Web site keywords/search terms).

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* 17. Other names you go by (maiden) or ways people incorrectly spell your name (for Web site keywords/search terms).

Add a photo to your provider bio!

Your photo must meet these requirements:

  • Color photo with a simple gray backdrop, showing head and shoulders
  • Photo resolution must be 300 DPI and (1650 X 2305 px)
  • Business attire (avoid lab coat, scrubs, large jewelry, seasonal/holiday clothing)
Upload your provider bio portrait for our website (see instructions)

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* 18. Upload your provider bio portrait for our website (see instructions)

GIF, JPEG, JPG file types only.
Choose File
No file chosen
Don't have a photo that meets the requirements? No worries! 

FPA Network will reimburse FHN providers for the cost of portraits, up to $50 each, with receipt. If your practice is not part of FHN, we can help you update your portraits at your expense.
 See below for options.
Please select one of these photo options and we will contact you to make arrangements:

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* 19. Please select one of these photo options and we will contact you to make arrangements:

Please enter your contact information (if different from provider).

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* 20. Please enter your contact information (if different from provider).

Additional comments, questions or requests?

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* 21. Additional comments, questions or requests?

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