Planning Your First Schwartz Rounds

Leadership Team Form

Please tell us which team member is filling out this form and from which organization.(Required)
First Name
Last Name
Organization
Please identify the name of your Schwartz Rounds Leadership Team Physician/Clinical Leader(s):(Required)
(You may add additional fields by clicking the "+" sign to the right)
Name
 
Please identify the names of your Schwartz Rounds Leadership Team Facilitators:(Required)
(You may add additional fields by clicking the "+" sign to the right)
Name
 
Please identify the name of your Schwartz Rounds Leadership Team Program Coordinator(s):(Required)
(You may add additional fields by clicking the "+" sign to the right)
Name
 
Who should be on your Planning Committee? Make a list of colleagues that come to mind as potential Planning Committee members. If you do not have specific names, make a list of roles or departments you might include.(Required)
(You may add additional fields by clicking the "+" sign to the right)
Name, role, or department
 
What are some potential topics and cases? Think of two or three relevant cases or topics that you can suggest to your Planning Committee.(Required)
(You may add additional fields by clicking the "+" sign to the right)
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