University of Illinois at Rockford - College of Medicine

Web Site Faculty Update

In order to create the department faculty pages for the College of Medicine at Rockford Web site, it is asked that all faculty members complete the following form to update personal information. Please do not send CVs. If you have any questions, contact prrockford@uic.edu.

Faculty Name (w/ certifications):

Would you like your picture on the Web site?: Yes No

Department(s)/Clinic(s):

Biomedical SciencesFamily & Community MedicineFiscal Affairs & AdministrationMedical Education & EvaluationMedicineNational Center for Rural Health ProfessionsOB/GYNPathologyPediatricsPsychiatryStudent AffairsSurgeryFamily Health CenterUniversity Psychiatric ServicesUPCC BelvidereUPCC Mt. MorrisUPCC RocktonWomen's & Children's Health CenterOther

Faculty Appointment:

Additional Title(s):


Clinical Interests:

Research Interests (Please be brief):

Undergraduate Degree (school name; year is optional):

If applicable, Graduate Degree(s) (school name; year is optional):

Medical Degree (school name; year is optional. If none, please put DNA):

Residency (If none, please put DNA):

Fellowship:

Awards and Special Recognition:

Professional Memberships:

Recent Publications (with year):

Patents:

Academic Office Address:

Academic Office Telephone:

E-mail:

Would you like your E-mail address published on the Web site? Yes  No

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