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The Center for Future Health Professionals
Dedicated to guiding future health professionals

Student or Resident Mentors

Thank you for your interest in the Future Health Professional Club Mentoring Program. To participate in the mentoring program, please fill out and submit your personal profile below.

Almost all fields are required for registration, however, only your name and e-mail address will be released to the mentee. Other information is for in-office use and matching purposes. At this time, 4th year medical students provide only online mentrship. All applicants will be matched. Please click here for a list of student mentors who have already registered.

Please click here to withdraw your participation.

Personal Information
Prefix:
First Name:
Last Name:
Professional School Name:
College name:
Work Information
Address:
Phone:
E-Mail Address:
(Matching results and notices will be sent to this address)
Your Ethnic Background (Optional)

Your Position
Professional School
Year in Professional School or Residency
Please indicate the type of mentorship you can provide (Can choose more than one option)
Online mentorship (See information e-mentoring)
Hospital tag along (Only available to residentand faculty mentors. See tag along)
Clinic tag along (Only available to resident and faculty mentors. See tag along )
Afterchool clubs (See information afterschool clubs)
Projects: Non-research related
Your Subspecialty Preference (Optional) Select from list: 
(CTRL + Click to select multiple)
Other:  
Student Status Preference
Number of students willing to mentor (optional)
Other Comments (Optional):
 

The Center for Future Health Professionals
University of California, Irvine Health Affairs
Behnoosh Afghani, MD
© 2007 The Regents of the University of California.
All Rights Reserved.
Last Updated: May 04, 2011

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