CIR Information Survey

The Council of Interns and Residents (CIR) is an entity within the Michigan Osteopathic Association whose purpose is to represent residents and bring forth concerns of residents and topics of interest to the MOA and AOA. The CIR has capabilities to further your career and your training through events, advocacy and mentorship opportunities. We would love to hear about your interests, passions, and career goals to better serve your needs and aspirations.

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* 1. Name

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* 2. Current City

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* 3. Home State

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* 4. Specialty

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* 5. Hospital/Institution

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* 6. Educational level

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* 7. Prior to this survey have you heard of the Council of Residents and Interns

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* 8. Which type of events would you be interested in? Please select all that apply

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* 9. Are there any TOPICS you would like us to cover in our discussion series? Please select all that apply

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* 10. Our goal is to advocate for residents and for our communities, and would like to know how we can help advocate for topics important to you/your program/your community. Please use this space to describe a topic you would like to advocate for:

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* 11. Would you be interested in becoming more involved with the MOA CIR as a member of our board or in a subcommittee?

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* 12. Please select from below:

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