Register – Research Community Engagement event | University of Michigan Precision Health

Name *

First

Last *

Last

Which best categorizes your relationship with Precision Health at U-M? *

Research Study Participant

Health Professional/Other community member

Precision Health Member (Data/resource user)

UM Faculty/Researcher (not yet a member)

Stakeholder/Supporter of Precision Health

Precision Health partner organization

Precision Health Grad Certificate student

Precision Health Staff

Other (please describe):Other (please describe):

Organization Name

Position/Title (for nametag purposes) *

Affiliated School/Department (for nametag purposes) *

Email *

Please indicate which pronouns you would like listed on your nametag: *

She/Her

He/Him

They/Them

Ze/Zim

I would not like my pronouns listed on my nametag

If your pronouns are not represented above, please share here:If your pronouns are not represented above, please share here:

We are glad you're attending! Do you have colleagues who might like to attend as well?

Yes, I have a colleague/colleagues who will join me

I might have colleagues who are interested; can you send them an invitation?

No, I do not plan to bring along any colleagues

Please share name and email of colleagues you would like us to invite:

We'll be serving breakfast- Do you have any dietary needs/restrictions we should be aware of? *

Comments or Questions

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