AUPN Chair-to-Chair Coaching Pairing (Mentee) | Association for University Professors of Neurology

AUPN Chair-to-Chair Coaching Pairing (Mentee)

Name (First & Last) *
Institution *
Email *
Phone *
What is your institution type? *

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Is your primary hospital owned by the University? *

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What is your residency size? *

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Number of full time primary faculty *
Does the Department include Child Neurology? *

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What issues do you most want to be matched for? *
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To help you with the next question, please click here to view our list of current Coaches looking for a mentee.

Please name up to 2 Chairs you would welcome as a Coach - You can select from the above list and/or name Chairs not on the list. *
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Please name any individuals would you prefer not to have as a Coach.
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Additional Comments (optional)
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