Young Member Mentorship Program Questionnaire

The intent of our AAPSM Young Member Mentorship Program (YMMP) is to connect members within the Academy and foster an ongoing, mutually beneficial relationship between the established sports medicine practitioner with our next generation of sports medicine podiatrists. If you are interested in participating,  please fill out the respective portion of the questionnaire.  If you have any questions, please reach out to Executive Director, Rita Yates at ritayates2@aol.com. 

Requirement:  Must be a member in good standing of the AAPSM. 

MENTOR

 Questionnaire to be filled out by the established AAPSM member at least 5 years from retirement:

* ALL Fields Required

Full Name:
Podiatric School Attended:
Graduation Date from Podiatry School:
Degree(s):
Years in Practice:
Specific Training:
Practice region/ location
Type of practice (i.e. private, ortho, multi-specialty, clinic, hospital, school)
Type of sports medicine involvement (i.e. local, state, national, international, amateur, collegiate, professional):
Specific area of interest, expertise, or involvement in sports medicine field:
Athletic activities you enjoy:
Preferred communication in this program (i.e. phone, text, email, FaceTime):
Preferred phone number, email, address:

 

  

---

MENTEE

 Questionnaire to be filled out by the AAPSM Young Member:

* ALL Fields Required

Full Name:
Podiatric School Attending/Attended:
Current year/degree/position:
Current region/location:
Preference in region of country to establish career:
Preference in Mentor - male, female, either:
Specific area of interest, expertise, or involvement in sports medicine field:
Athletic activities you enjoy:
Preferred communication in this program (i.e. phone, text, email, FaceTime):
Preferred phone number, email, address: