Be a part of our Membershipinfo@scrubsisters.org(949) 289-1618 Name * First Name Last Name Email * State * Country * Country Current Professional Level * Pre-Medical Student Medical Student (MD/DO) Resident Fellow Early Career Physician Mid/Late Career Physician Retired Other Please provide your medical school information or NPI number to confirm you are either in training or a practicing MD/DO. * Marital Status Single Married Living with Partner Divorced Widowed Other Do You Have Children? Yes No If you have children, how many and what ages? What medical specialty/subspecialty do you currently practice or are currently interested in practicing? Are you in a non-clinical position? * Which topics are you interested in discussing with your Scrub Sisters? Are you interested in joining one of our Committees? Pre-Medical Students Medical Students (MD/DO) Residents/Fellows Early Career Physicians Mid/Late Career Physicians Membership Mentorship Social Media Scholarship Program Advocacy Mentorship Program Speaker Series Local Chapters What are the biggest challenges you are currently facing as a female in medicine? Are there any policies in your institution or workplace that are supportive of females in medicine? If so, what are they? What policies in your institution or workplace could be changed to better support females in medicine? Sleep: Do you feel that you get the recommended hours of sleep most of the time? Yes No I'm not sure Nutrition: How many days of the week do you feel that you are eating well? 1-2 3-5 6+ Exercise: Are you able to exercise the recommended 5 days of the week? Yes No Sometimes Stress: Do you feel that you have strategies to manage this short term and long term? Yes No Sometimes Would you be interested in becoming a: * Mentor Mentee Mentor and Mentee None at this time Can you tell us a fun fact about YOU? We’re SO glad you’re joining us! Can’t wait to have you as a sister.Someone from our team will be back in touch with you soon.
