Guideline Task Force Application

Gender

Are you of Hispanic or Latinx ethnicity?

What is your race? (select all that apply)

Geographic Location

Practice Type

Statements and Documents *Required

Please submit one document with the following:

1. A statement of interest (100-300 words) should address the bullets noted below. Applicants should have depth of understanding and strong interest in caring for patients with this disease. 
   • Clinical experience managing this disease site
   • Experience developing evidence-based standards of care (e.g., evidence-based guidelines) on this or other disease sites
   • Relevant publications or clinical trial experience
   • Experience teaching about or presenting on this disease site
2. Describe why you think clinical practice guidelines are important, and why you wish to participate in the creation of this guideline topic. (250-word-limit)
3. What experience do you have with diversity, inclusion, health equity and/or disparities as it relates to the guideline topic? (250-word-limit)
4. Your curriculum vitae (CV).

Upload your statements of interest (compile into one document)

Upload your curriculum vitae (CV)