We are open to FEMALE allopathic and osteopathic medical students, residents, and those in practice with a license that can be verified. If you submit this form as another provider (NP, PA, DDS, etc) then we will ignore and delete your request.
Your Facebook account must be personal and not shared with a partner/friend. Names that indicate a shared account (DickandJane) will not be allowed for privacy purposes.
Our admins verify every submission through state/province license check SO ANSWER ALL OF THE QUESTIONS!
If you are a medical student or have a work badge photo to confirm your identity you can email it to firstname.lastname@example.org