PALISI GH Roster — PALISI Global Health

Thank you for your interest and involvement with PALISI Global Health. In order to build a stronger network of globally-minded pediatric intensivists, please complete this short form to be added to our roster.

Name

First Name

Last Name

Email Address

Home institution

Affiliated hospital/institution(s) abroad

Research/project location (City, Country)

Global health research focus

Check as many as apply:

General pediatric critical care

Neurocritical care

Cardiac critical care

Education/capacity building

Other (describe below):

Brief global health research/project description:

Research needs and/or resources needed (e.g. study coordinators, medical student volunteers, grant funding, local partners, etc.)

How can PALISI Global Health help meet your project needs?

Would you like your name, institution, and brief description of research interests listed on the PALISI Global Health website?

Yes

Comments or questions: