Alumni Survey
RVU ID Number
First Name
Last Name
Graduation Year
Specialty
Specialty Other:
Residency Program
Location City
Location State
Still Attending?
Fellowship Program
Practice Name
Would you be willing to talk with RVUCOM students about your residency program and/or fellowship?
Would you be willing to come to campus to meet with RVUCOM students?
Would you be willing to host students on audition rotations?
Would you like to receive the RVU Connection?
Would you have an interest in serving on the Alumni Association Board of Trustees?
Preferred method of contact (phone/email)
Phone Number
Email
Comments
For questions, please contact Julie Rosenthal at
jrosenthal@rvu.edu