ObGyn Faculty Information Update

Thank you for helping us keep our records and our web site up to date, by providing us with the following information.

Name Name First Last
Preferred pronouns

e.g. they/them, she/her, he/him
Your primary hospital or clinic affiliation
Secondary or other hospital clinic affiliation (if applicable)
Type of appointment in Ob-Gyn

Type of appointment in Ob-Gyn A primary appointment in Ob-Gyn A cross appointment in Ob-Gyn
Division

Division Core Ob-Gyn (clinical/generalist) Gynaecologic Oncology (clinical) Maternal-Fetal Medicine (clinical) Paediatric and Adolescent Gynaecology (clinical) Reproductive Endocrinology and Infertility (clinical) Urogynaecology (clinical) Reproductive Sciences (basic science)
Additional clinical/academic focus

Additional clinical/academic focus Minimally Invasive Gynaecologic Surgery (clinical) Global Health and Advocacy
Information for internal use

The information below is for use within the Department, and will not be shared publicly in any way.
Your primary email address

Please provide us with your preferred email address. This address will be used for our important announcements and monthly newsletter. This is for internal departmental use only, and will not be made public.
Secondary email address (if applicable)

This is for internal departmental use only, and will not be made public.
Phone number where department staff can reach you (add extension below, if needed) Phone number where department staff can reach you (add extension below, if needed) - ### - ### ####

This is for internal departmental use only, and will not be made public.
Phone number extension (if applicable)
Assistant's name (if applicable) Assistant's name (if applicable) First Last
This is for internal departmental use only, and will not be made public.
Assistant's email (if applicable)

This is for internal departmental use only, and will not be made public.
Assistant's phone (if applicable) Assistant's phone (if applicable) - ### - ### ####

This is for internal departmental use only, and will not be made public.
Assistant's phone number extension (if applicable)
Office address Office address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
This is for internal departmental use only, and will not be made public.
Office fax number Office fax number - ### - ### ####

This is for internal departmental use only, and will not be made public.
Directory Information

The following information will be used to update your profile in the faculty directory on our website.
Click here for an example of a fully completed profile.
Please indicate how your name typically appears in research citations:

e.g. Kingdom JC
Post-nominal designations (e.g. MD, PhD, FRCSC, etc.)
Upload Photo

Attach Files

Please provide a headshot for use in the faculty directory.
Short biography (250-500 words)

250 - 500 words. This section is for a short biography. This can include explanations about your education, past positions, current position, research interests etc.
Clinical interests

List your clinical interests, using commas between each topic.
Research interests

List your research interests, using commas between each topic.

ObGyn Faculty Information Update

ObGyn Faculty Information Update

Information for internal use

Directory Information