The Voice of Academic Neurology's Leaders

Institutional Profile Form

All membership category positions listed below are covered by the AUPN annual dues and therefore are entitled to all AUPN benefits. This includes receiving the weekly Saturday emails.

If there is not an individual in a specific role, please leave blank.

Please contact neuro@aupn.org with questions.

Institution Contact Information:

Institution Name *
Institution Address
City
State
Zip
Phone

Neurology Department Chair (billing contact)

Chair Name (first, last)
Suffix (MD, PhD, etc.)
Nickname (if applicable)
Email
Phone (if different than above)

Residency Program Director

Program Director Name (first, last)
Suffix (MD, PhD, etc.)
Nickname (if applicable)
Email
Phone (if different than above)

Clerkship Director

Clerkship Director Name (first, last)
Suffix (MD, PhD, etc.)
Nickname (if applicable)
Email
Phone (if different than above)

Child Neurology Residency Program Director

Child Neurology Program Director Name (first, last)
Suffix (MD, PhD, etc.)
Nickname (if applicable)
Email
Phone (if different than above)

Research Program Director

Research Program Director Name (first, last)
Suffix (MD, PhD, etc.)
Nickname (if applicable)
Email
Phone (if different than above)

VA Director

VA Director Name (first, last)
Suffix (MD, PhD, etc.)
Nickname (if applicable)
Email
Phone (if different than above)





Fields marked with * are required.

Your form submission WILL be encrypted using SSL to ensure your privacy.

MEMBERSHIP
EDUCATION
JOB BOARD
5841 Cedar Lake Road, Suite 204 | Minneapolis, MN 55416 | 952-545-6724 | neuro@aupn.org
© 2021 Association of University Professors of Neurology. All rights reserved. Articles of Incorporation | Terms of Use | Privacy Policy
Reset password
NEWS

 

New Chair at USU, Upcoming Summer Program, Fiscal Pressures In Academic Neurology…

New Chair at Dartmouth, Leadership Minutes x2, New Program Friday May 14…

New Chair at Beth Israel Deaconess, Recruiting Med Students into Neurology, New Chair Openings…

New Tulane Chair; AUPN Elections; Spring Sessions; Faculty Morale….

Welcome New Chair - Dr. Panayiotis Varelas; An Epidemic of Unmatched Med Students.

Teaching Millennials and Gen Z; Improving Faculty Evaluations…

Academic Neurology in the Digital World, Winter Programs Launch…

Call for UCNS Delegate, Winter Programs, Leadership Minute

Meeting with your Dean, Chair Mentor Program, COVID Vaccine in Perspective…

The Academic Value of the VA; Fall Chair’s Sessions on Demand

VIEW MORE