1.Full name

2.Email address

3.Current professional affiliation

4.Briefly describe your experience relevant to lower extremity amputation prevention

5.Why are you interested in joining the LEAP 2026 Scientific Committee?

6.Please indicate your areas of expertise (select all that apply):

Podiatry

Wound Care

Research

Diabetology

Vascular Surgery

Rehabilitation

Nursing

Other (please specify below)

7.If you selected 'Other', please specify your area of expertise.