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Faculty Submission Form
Faculty Submission Form
Do you already have a profile in this collaboration database?
(Required)
Yes - please update my entry
No - please create one for me
First Name
(Required)
Last Name
(Required)
Your Organization
(Required)
Novant Health
ºÚÁÏÍø / ºÚÁÏÍø Health
Market Segment
(Required)
Which market are you associated with [Choose one]
Coastal
Enterprise-wide
Greater Charlotte
Greater Winston-Salem
Your Organization Email
Display Name
(Required)
[First Name Last Name, Degrees] This will be how your name will display in the database.
ºÚÁÏÍø Bio URL
Please use a link to a ºÚÁÏÍø-affiliated website for other faculty to learn more about your bio/background
Novant Bio URL
If desired, please enter a link to your Physician Finder page or professional website for other faculty to learn more about your bio/background.
Publications URL
Please use OrchID, PubMed, etc.
Description of your Clinical and/or Research Focus
Institute/Department Affiliation
(Required)
Please select which institutes/departments you are currently affiliated with (if you are unsure, or do not see your department listed, select the best fit):
Cancer
Community Health & Wellness
Heart & Vascular
Hospital-based Medicine
Institute of Innovation & Artificial Intelligence
Neurosciences
Office of Health Equity
Orthopedics & Sports Medicine
Pediatrics
Post-Acute Care
Psychiatry & Mental Health
Surgical
Women’s & Children’s
ºÚÁÏÍø Center/Department Affiliations
(Required)
Please select which ºÚÁÏÍø Centers and/or Departments you are currently affiliated with.
(AHS) Clinical Laboratory Science
(AHS) Clinical Rehab and Mental Health Counseling
(AHS) Occupational Science and Therapy
(AHS) Physical Therapy
(AHS) Physician Assistant Studies
(AHS) Radiologic Science
(AHS) Speech and Hearing Sciences
(DOM) Cardiology
(DOM) Endocrinology & Metabolism
(DOM) Gastroenterology & Hepatology
(DOM) General Medicine and Clinical Epidemiology
(DOM) Geriatric Medicine
(DOM) Hematology
(DOM) Hospital Medicine
(DOM) Infectious Diseases
(DOM) Nephrology & Hypertension
(DOM) Oncology
(DOM) Pulmonary Diseases & Critical Care Medicine
(DOM) Rheumatology, Allergy & Immunology
Allied Health Science (AHS)
Anesthesiology
Biochemistry & Biophysics
Bioinformatics & Computational Biology
Biology
Biomedical Engineering
Biomedical Research Imaging Center (BRIC)
Biostatistics
Blood Research Center
Bowles Center for Alcohol Studies
Carolina Institute for Developmental Disabilities (CIDD)
Carolina Population Center
Cell Biology & Physiology
Center for Aging & Health
Center for AIDS Research (CFAR)
Center for Bioethics
Center for Environmental Medicine, Asthma & Lung Biology (CEMALB)
Center for GI Biology and Disease (CGIBD)
Center for Health Equity Research
Center for Maternal & Infant Health
Center for Nanotechnology in Drug Delivery
Center for Women's Health Research
Chemistry
Children's Research Institute
Computational Medicine Program
Computer Science
Department of Medicine (DOM)
Dermatology
Emergency Medicine
Epidemiology
Family Medicine
Genetics
Gillings School of Public Health
Graduate Education
Health Behavior
Institute for Global Health & Infectious Disease
Integrative Program for Biological & Genome Sciences (iBGS)
Kidney Center
Lineberger Cancer Center
Marsico Lung Institute
Mathematics
McAllister Heart Institute
Microbiology & Immunology
Neurology
Neuroscience Center
Neurosurgery
Nutrition
Obstetrics & Gynecology
Ophthalmology
Oral Biology
Orthopaedics
Other
Otolaryngology/Head & Neck Surgery
Pathology & Lab Medicine
Pediatrics
Pharmaceutical Sciences
Pharmacology
Physical Medicine and Rehabilitation
Physics & Astronomy
Program for Precision Medicine in Healthcare (PPMH)
Psychiatry
Psychology & Neuroscience
Radiation Oncology
Radiology
Sheps Center for Health Services Research
Social Medicine
Statistics and Operations Research
Surgery
Thurston Arthritis Center
Toxicology
Translational Medicine
Urology
Virology
Women's Health
Other ºÚÁÏÍø Center and/or Department Affiliation
(Required)
Clinical and/or Research Interests
(Required)
Please choose any areas in which your current research or clinical practice is focused. If you do not see an area and/or an interest in the list, you can select
"Other"
and fill in blank field below the options, or you can include the areas you focus on in the
"Description of your Clinical and/or Research Focus"
text field above.
Addiction/Substance Use Disorder
Aging/Geriatrics
Apps-Devices
Arthritis
Autism
Bacteriology
Behavior
Biochemistry
Bioethics
Bioinformatics
Biomaterials
Biomechanics
Biomedical Engineering
Biophysics
Cancer
Cancer Biology
Cardiovascular Biology
Cardiovascular disease
Cell Biology
Cell Signaling
Chemical Biology
Chronic Kidney Disease
Clinical Informatics
Clinical Trials
Comparative Effectiveness
Computational Biology
Criminal Justice
Developmental Biology
Diabetes
Drug Delivery
Drug Discovery
Ecology
Education Research
Electronic Medicine
Epigenetics and Chromatin Biology
Evolutionary Biology
Gastrointestinal Biology
Gene Therapy
Genetics
Genomics
Global Health
Health Equity
Health Informatics
Health Services
Hearing-Speech
Hematology
HIV/AIDS
Imaging
Immunology
Implementation Science
Inflammatory Bowel Disease
Medical Education
Mental illness
Metabolism
Microbiology
Microscopy
Mineralized Tissue
Molecular Biology
Molecular Medicine
Nanomedicine
Neurobiology
Obesity
Occupational Science/Therapy
Organismal Biology
Orthopaedics
Other
Pathogenesis & Infection
Pathology
Pediatrics
Pharmacology
Physical Therapy
Physiology
Plant Biology
Population-based
Prostate Cancer
Pulmonary
Quality and Patient Safety
Quality of Life
Quantitative Biology
Regenerative Medicine
Rehabilitation
Rural Health
Sarcopenia
Sexual and Gender Minorities
Sleep
Social Determinants of Health
Social Medicine
Stem Cells
Structural Biology
Surgery
Systems Biology
Toxicology
Translational Medicine
Veteran’s Health
Virology
Women's Health
Other Research and/or Clinical Interests
(Required)
Your Headshot
Please upload a recent photo for inclusion in your entry
Accepted file types: jpg, jpeg, png, gif.
Email
This field is for validation purposes and should be left unchanged.
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