ASK A DOCTOR NETWORK
Expert Application

Please complete the required fields below. All application materials MUST be submitted for consideration into our Ask a Doctor Network. We will send an email confirmation once we receive your completed application. If you have any questions, please feel free to contact us at any time.

PERSONAL
* First name
  Middle initial
* Last name
* Gender
* Email
* Place of work
* Work address
*  Work telephone number
(medical practice, hospital, clinic, etc. no cell phones, please) ( Why this? )
* Maximum questions that you can answer per day
* Days you are available to answer medical questions
Sun Mon Tue Wed Thu Fri Sat
 
EDUCATION
* University name
* Date of graduation
* Degree, Diploma, Certification
* Area of medical practice
* State/Nation in which I am licensed
* Certification/registration number
  Other evidence of formal qualification
 
SPECIALTY
  Do you have a certification of specialist training?
  In which forums would you like to answer medical questions?
Any forum



 
ATTACHMENTS
1. Photo - Your photo will appear next to your posts, and on your profile page.
 
2. CV - Please include a list of your medical training, professional affiliations and publications in your current CV. We list these details on your profile page.
 
3. Formal qualification documents - Please send us a copy of your State Board of Medical Examiner`s license, certification, sub-certification or registration document. We verify the status of all applicants` issued credentials.
 
 
TO SUBMIT BY FAX: Please fax a photo, CV and copy of your qualifying document(s) to (954)697-3100.
TO SUBMIT ELECTRONICALLY: Please upload the following documents:
  • The documents can be in RTF, DOC, DOCX or TXT format
  • The documents can be a JPG, GIF, or PNG image
 
 
By clicking "I Agree" below you agree and consent to our Ask a Doctor Publishing Agreement.
 
I Agree
 
Ask a Doctor Testimonials
"I was very much impressed by the answer your doctors provided, and guess what? I visited my doctor and he agreed with you. Thank you so much and I will be visiting very often. Once again, many thanks!!!!!!!!!"
- shana456