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2006-2007 HPM STUDENT PRACTICUM SURVEY

In order to assist you in the search for a rewarding practicum, we request that you complete the following questionnaire. Please attach a 1-page resume suitable for distribution and submit the survey and resume to Debra Osinsky prior to your scheduled meeting. This information will help clarify your specific needs and interests as we work together to ensure the best summer placement for you. If you have any questions, please contact Debra Osinsky at 305-3579 or do79@columbia.edu.

Name_____________________________________________________________________

Local Address_______________________________________________________________

Phone______________________________  E-mail_________________________________

Concentration  ___Policy ___Management ___ EOR     Second Language: _________________

Advisor_______________________________________________________________

Permanent Address______________________________________________________

 
___Bioethics
___Bioterrorism
___Child Health
___Clinic Management
___Community Health
___Disease Prevention/Health Promotion
___Effectiveness and Outcomes Research
___Environmental Health Management
___Government
___Health Care Consulting
___Health Education
___Health Insurance
___Health Planning
___Health Policy Research (government)
___Health Policy Research (non-govt)
___HIV/AIDS
__HMOs
  ___Hospital Management
___Information Management Systems
___International Health
___ NGOs
___Managed Care
___Media/Communications
___NYC Department of Health
___Non-Profit Health Care Organizations
___Occupational Health
___Pharmaceutical Research/Marketing
___Program Evaluation
___Public Health Advocacy
___Public Health Law/Policy
___State Health Department
___West Nile Virus
___Women’s Health



Other (please specify)_____________________________________________________________

____________________________________________________________________________

Additional Comments: _____________________________________________________________

____________________________________________________________________________

LOCATION: (Please indicate if you would like to work in a medically underserved area or in a specific geographic location)__________________________________________________________________
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