Committee Activity Follow-up Committee Activity Follow-up Form All MCC Committees must submit this form no later than 3 days following the event. Committee Name*AnesthesiologyCardiologyCritical CareDermatologyDiagnostic RadiologyEmergency MedicineFamily MedicineGastroenterologyGeneral SurgeryGeriatric MedicineImmunology and Infectious DiseaseInternal MedicineInterventional RadiologyNeurological SurgeryNeurologyObstetrics and GynecologyOncologyOphthalmologyOrthopaedic SurgeryOtolaryngologyPain MedicinePathologyPediatricsPhysical Medicine and RehabilitationPlastic SurgeryPsychiatryRadiation OncologySports MedicineThoracic and Cardiac SurgeryUltrasoundUrologyWilderness MedicineArtificial Intelligence in MedicineArts in MedicineBusiness and Innovation in MedicineGlobal Surgery and MedicineMedical EducationMind-Body MedicineNutritionHealth Policy and AdvocacyName* First Last Email* Event Request Form Number*Input the form number correlated with your initial event request. Event Title*This is how your event will appear on the MCC calendar. Event Type*You may check multiple boxes if more than one applies. General Meeting Workshop/Seminar Special Event/Series Date of Event* MM slash DD slash YYYY Event Description*How did this event benefit the UF COM community? What were the learning outcomes?*Attendance*Provide the final attendance number (or your best estimate.) Event Photo*Please provide an image from the event. You may need to compress your photo prior to submission. Max. file size: 125 MB.Terms*By completing this form, I certify the above information is accurate. Failure to provide accurate follow up feedback and information, may prevent your Committee from hosting events for the remainder of the academic year. Agree
