Questions on the Med Society Application

  • Basic Info
    1. Contact Info
      • First Name
      • Last Name
      • Email
    2. Birthday
    3. Gender
    4. Languages you speak
    5. Home Address
      • Address
      • Address 2
      • City/Town
      • State/Region/Province
      • Zip/Post Code
      • Country
    6. Medical Society Interest
  • Medical Information (if applicable)
    1. Your specialties
    2. Published Articles/Reports
    3. Board Certifications
  • Practice Information (if applicable)
    1. Address of Practice
      • Address
      • Address 2
      • City/Town
      • State/Region/Province
      • Zip/Post Code
      • Country
    2. Hospital Affiliation
    3. Insurance Accepted?
    4. Insurances Accepted
    5. Work with Special Interest Groups?
    6. Hours of operation
    7. Type of Practice
    8. Current Postion
    9. What is the average amount of time you spend with a patient?
    10. How many other doctors work in your practice (if applicable)
    11. What other specialties are offered at your practice? (if applicable)
  • Doctors – General Info
    1. Why Did You Become a Doctor?
    2. What areas of medicine/science are you concerned about?
    3. What area of medicine/science are you pleased with?
    4. What brought you to the Broken Science Initiative?
  • Personal Info
    1. Non Medical Certifications
    2. Your Diet
      • Diet (if other)
    3. Exercise Routine
    4. Favorite book on health
    5. Biggest concern with modern healthcare system
    6. Your wish for a future medical system
  • Interests and Hobbies
    1. Research Interests
    2. Hobbies
    3. Reason for joining the BSI Medical Society