Finding Meaning in Medicine - ISHI

(To register and participate you must be a physician or a Healer's Art Course Director.)

Our mailing lists are used solely for the work of ISHI/Commonweal; this information will not be shared or sold.

Participant Registration Form

Red = Required Fields

First Name:

Last Name:

Degree (current or anticipated)

I am registering for the following discussion group(s):

Click on all that are relevant to your professional status. At least one must be selected but you may select more than one, as is appropriate.

To participate in the Healer's Art discussions, you must currently be a course director at a medical school which offers, or will soon offer the course. Please contact us at ishi@commonweal.org for more information about The Healer's Art.

All groups will be able to participate in their appropriate FMM Facilitator Forum.

Physician Healer's Art Course Director

Medical/Professional School:

Year Graduated
(or will graduate)

State of Medical/Professional License:
(enter "none" if you currently
do not have an active license)

Medical/Professional License #:
(enter "none" if you currently
do not have an active license)

Email/Login:

Preferred Password:
(3-8 characters; alpha-numeric)

Confirm Password:

Address (Line 1):

Address (Line 2):

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Date of Birth:

Gender:

M F

Medical/Professional Specialty:

Areas of Medical/
Professional Activity
(check all that apply):

Clinical Practice

Education

Research

Admin

Do you want to be
an FMM Group Facilitator?

Yes No Not Sure

Do you plan to use FMM

In your medical school?
Yes No Not Sure

In your residency program?
Yes No Not Sure

Are you already an FMM Group Facilitator?

Yes No

If you are an FMM Group Facilitator, or you are in the process of starting a new FMM group, please answer the following:

Number of participants
in your FMM group:

If you are running an FMM group or planning to start one, or if you would like to join others in your area in an FMM group, we'd like to list your contact information in the secure, participants-only section of the website. We will list your name, city, state and country (if outside the US) and your email address.

May we post your FMM group contact information in the private "participants only" area of this FMM web site?

Yes No

Add me to your mailing list. (To be added to our "snail-mail" list and receive our periodic announcements and mailings, please provide your preferred mailing address above.)

[top of page]