Do you have a preference of which faculty member to meet with? (Please select all that apply)

What is your preferred time of day for the meeting? (Please select all that apply)

What is your preferred day of week for the meeting? (Please select all that apply)

I understand that I will receive an educational video by email on current approaches to LGSOC diagnosis and treatment, and will review it before my one-on-one discussion.

I understand that this call-in line is for educational purposes only and will not be used to provide medical advice, diagnose conditions, or establish patient-specific treatment plans.

I agree to maintain confidentiality, refrain from discussing identifiable patient information, and comply with HIPAA regulations and applicable privacy laws.

I acknowledge and consent to the recording of the meeting, as well as the use of artificial intelligence (AI) tools for transcription. The transcription will be used to summarize data collected during the meeting, and a summary may be shared with the program sponsor. My full name and other identifying information will not be disclosed. All recordings and transcripts will be managed in accordance with applicable privacy and confidentiality standards