Resident survey

Question Title

1. Please provide your contact information

Name

City / Town

State / Province

Question Title

2. Summarize your educational background

Question Title

3. What date are you available?

Question Title

4. Date of Boards (taken or scheduled to take)

Question Title

5. J1/H1B status?

Question Title

6. Do you have interest in practicing in a rural or urban area?

Rural

Urban

Other (please specify)

Question Title

7. Where (geographic area) in NYS would you like to practice?

Capital Region

Syracuse area

Rochester area

Buffalo area

Binghamton area

Downstate (Hudson Valley, Poughkeepsie area)

NYC area

Long Island

Other (please specify)

Question Title

8. Which practice style is your preference?

multi-specialty group practice

hospitalist

academia

global health

research

sports medicine

public health

maternity care

emergency medicine & urgent care

Other (please specify)

Question Title

9. Do you have a preference of your practice setting?

office practices

hospitals

nursing homes

community health centers

urgent care centers

emergency rooms

university-based health centers

Other (please specify)

Question Title

10. Are you looking for:

FT employment

PT employment

Other (please specify)

Resident survey

Question Title

1. Please provide your contact information

Question Title

2. Summarize your educational background

Question Title

3. What date are you available?

Question Title

4. Date of Boards (taken or scheduled to take)

Question Title

5. J1/H1B status?

Question Title

6. Do you have interest in practicing in a rural or urban area?

Question Title

7. Where (geographic area) in NYS would you like to practice?

Question Title

8. Which practice style is your preference?

Question Title

9. Do you have a preference of your practice setting?

Question Title

10. Are you looking for:

Question Title

11. Do you have any special interests and / or hobbies?

Question Title

12. Additional comments/ special interest in medicine?

Question Title

* 1. Please provide your contact information

Question Title

* 2. Summarize your educational background

Question Title

* 3. What date are you available?

Question Title

* 4. Date of Boards (taken or scheduled to take)

Question Title

* 5. J1/H1B status?

Question Title

* 6. Do you have interest in practicing in a rural or urban area?

Question Title

* 7. Where (geographic area) in NYS would you like to practice?

Question Title

* 8. Which practice style is your preference?

Question Title

* 9. Do you have a preference of your practice setting?

Question Title

* 10. Are you looking for:

Question Title

* 11. Do you have any special interests and / or hobbies?

Question Title

* 12. Additional comments/ special interest in medicine?

1. Please provide your contact information

2. Summarize your educational background

3. What date are you available?

4. Date of Boards (taken or scheduled to take)

5. J1/H1B status?

6. Do you have interest in practicing in a rural or urban area?

7. Where (geographic area) in NYS would you like to practice?

8. Which practice style is your preference?

9. Do you have a preference of your practice setting?

10. Are you looking for:

11. Do you have any special interests and / or hobbies?

12. Additional comments/ special interest in medicine?