ACAAM Rotator Tracking 2024-2025

ACAAM Rotator Tracking 2024-2025

Name

Pronouns

Email Address

Postal Address

Program

Primary Specialty

Availability for Observation

Please select a minimum of two weeks (M-F) that you will be available for a one-week virtual observation.

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What time of day works best for you?

Select

Additional Availibility Information

We strive to be flexible with everyone’s schedule-- is there anything else you think helpful for us to know about your availability? Please note- we cannot guarantee anything.

Adolescent/Young Adult Care

Do you care for adolescent/young adult patients, or will you in the future?

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Adolescent/Young Adult Care (cont.)

If yes, please use 100 words or less tell us about that. If no, leave blank.

Teaching in Addiction Medicine

Are you currently, or will you be teaching addiction medicine fellows?

Select

Teaching in Addiction Medicine (cont.)

If yes, please use 100 words or less tell us about that. If no, leave blank.

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