ADFM Administrator Peer Partner Request From

The goal of this program is to match seasoned ADFM Administrators (2+ years in a department) with new ADFM Administrators (< 2 Years) in DFMs to assist with the transition to a DFM Administrative Role and to improve specific knowledge, skills and abilities related to the role of an administrator. Additionally, the program aims to facilitate a better understanding of the ADFM culture for new administrators.

Please take a moment to provide some details about yourself and department/institution.

Learn more about this program on our site: https://adfm.org/programs/administrators-peer-partner-program/

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* 1. Name:

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* 2. Current Job Title:

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* 3. Department/Institution Name:

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* 4. E-Mail Address:

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* 5. How long have you been in your role?

Under 3 years

3 to 5 years

5 to 10 years

More than 10 years

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* 6. Describe your department setting.

Allopathic Medical School (MD)

Osteopathic Medical School (DO)

Regional Medical Center (e.g., stand-alone programs)

Other (please specify)

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* 7. Is your institution private or public?

Private

Public

Other (please specify)

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* 8. What do you consider your department to be in terms of size?

Small

Mid-size

Large

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* 9. What are you looking for in a peer partner?

Looking for a mentor

Looking to be a mentor