We look forward to you joining us at the New Jersey Pediatric Psychiatry Collaborative (NJPPC) Northern Regional Dinner and CME Presentation, "Anxiety and OCD in Pediatric Primary Care: Diagnosis and Management” with Sabina Mushtaq, MD. The event will be held at Maggiano's Little Italy (70 Riverside Square Mall, Hackensack, NJ 07601) on Tuesday, May 21, 2024, from 5 pm to 8 pm—additional details to follow.

*1.Demographics(Required.)

First Name

Last Name

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

Practice/Organization Name

Email Address

Phone Number

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

Attending

Resident

Other (please specify your position)

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

I am a NJPPC member

I am not a NJPPC member 

Unsure if I am a NJPCC

4.What questions do you have for our presenter on the topic of anxiety and OCD in pediatric patients?

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

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