AADE in Practice Reviewer Submission Form Thank you for your interest! Please complete the following form to join the AADE in Practice reviewer list. The information you provide will help us select articles for your review that you may find most interesting. Review requests go out based on the article submissions we receive. We hope everyone has an opportunity to participate as needs arise. Question Title * 1. First name Question Title * 2. Last name Question Title * 3. Credentials Question Title * 4. Email address Question Title * 5. City and state Question Title * 6. Phone number Question Title * 7. Select your practice setting. Primary Care Setting Endocrinologist Office Integrated Health Network Health Plan Academic Setting Public Health/Community Center Outpatient Diabetes Center Hospital Inpatient Hospital Ambulatory Care Services Hospital Pharmacy Community Pharmacy Pharmacy Benefits Manager Long Term Care Facility/Skilled Nursing Facility Military Base/Government Facility/VA Hospital Home Care Services/Organization Indian Health Services Industry (Pharmaceutical, Medical Equipment, etc.) Independent Practice (please specify below) Other (please specify below) Please specify above response Question Title * 8. Which patients do you work with most? Check all that apply. Kids Teens Adults Elderly Question Title * 9. Please describe your area(s) of expertise/interest. Submit