ASRS Retina Practice Mentor Application
Thank you for your interest in the ASRS Retina Practice Mentorship Program! Selected mentors will be asked to attend a virtual mentor training session. Mentors and mentees will be matched based on the information gathered through the application process, and will be expected to communicate at regular intervals. In order to participate, you must be an active Retina Practice Administrator Section member, and be willing to affirm your commitment. If you are interested, please fill out application no later than January 14, 2022. We hope that mutually meaningful mentorship relationships will be fostered through this program. If you have any questions, please do not hesitate to contact email@example.com.
Thank you for your interest! In addition to this form, please submit a resume and professional biography (not to exceed 1 page) to Monica Horton, Director of Practice Management at: firstname.lastname@example.org.