Reunion Survey

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Reunion Survey

Survey results will be compiled into a complimentary Reunion Memory Book made available to all alumni from your class who complete a survey or attend reunion.

Graduation year:
Do you plan to attend Reunion?	Yes No
Name:
Home address:
Home phone:
E-mail:
Register me for the online SOM E-mail Directory:	Yes No
Name & address of practice/hospital:
Business phone:
Fax:
Spouse's name and occupation:
Children's names and ages:

Survey Questions:

Which professor/instructor from medical school had the most influence on you?

What advice would you offer to those entering medicine?

What is your greatest accomplishment since graduating from the Boonshoft School of Medicine?

Have you had any out-of-the-ordinary or interesting life events since graduating?

What is your current professional situation? Are you still practicing medicine?

What do you do to cope with the stress of practicing medicine?

Complete this sentence: "One thing you probably don't know about me is..."

We would love to hear from everyone from the Reunion Weekend classes. Please submit this survey even if you are unable to attend the Reunion. Thank you for your time, and we look forward to seeing you at reunion!

You may also fill out this form, print it and send a copy to:

Office of Advancement
Boonshoft School of Medicine
3640 Colonel Glenn Highway
Dayton, OH 45435

(937) 775-2972
FAX: (937) 775-3254