Rotation Preferences Survey Name(Required) First Last Students will spend at least two weeks on an inpatient Neurology service, one week will be in our outpatient clinics, with an additional week on one of two other services (Neuro Intensive Care, VA, Unit or Pediatric Neurology). For the rotation preference survey, please indicate your order of preference between the Neuro ICU, VA or Pediatric Neurology. Assignments will be given based on availability of each service.(Required)1st Choice(Required)Neuro Intensive Care UnitVAPeds ACHPlease select one.2nd Choice(Required)Neuro Intensive Care UnitVAPeds ACHPlease select one.3rd Choice(Required)Neuro Intensive Care UnitVAPeds ACHPlease select one.Emergency phone contact(Required)Known Absences: i.e. Will you absent for any amount of time during your Neurology Rotation? This includes nights and weekends! *This could be 1 hour during the middle of the day or an entire day.(Required)Do you have a VA badge?(Required) Yes No
