Join the Diaries Cast

Audition for the Diaries Cast:

Share your story with the world! Be a part of the Diaries Cast!

We especially encourage women and ethnically-diverse
individuals to participate. We want the Diaries project to reflect
the diversity of the real-life medical community!

Your Name:

Your E-mail:

Birthplace:

Ethnic Identification:

Academic Affiliation:

Education Status:

Favorite Movie:

Favorite Music:

Favorite Place:

Greatest Ambition:

Gender:

F M (required)

Describe yourself in a sentence :

Tell us why you want to be part of the Doctor Diaries :

Describe a day in your life:

(Remember to include your e-mail
address if you would like a response!)

Your Name:
Your E-mail:
Birthplace:
Ethnic Identification:
Academic Affiliation:
Education Status:
Favorite Movie:
Favorite Music:
Favorite Place:
Greatest Ambition:
Gender:	F M (required)
Describe yourself in a sentence : Tell us why you want to be part of the Doctor Diaries : Describe a day in your life: (Remember to include your e-mail address if you would like a response!)



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