* 1. What is your name?

* 2. What is your email address?

* 3. Type of Healthcare provider

* 4. Years of practice

* 5. Primary work environment

* 6. Would you like to join the Excellence in Pediatrics Community? Improvement in pediatrics always comes through collaboration and exchange. Become member of the Excellence in Pediatrics Community, connect with your colleagues, share knowledge, ideas and practices that help improve children's health globally. It is free

* 7. Tell us how you could contribute to our mission:

* 8. Would you like to join one or more of the Special Interest Groups of the community?

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