SIMPLE

Simple Case Access and Pilot Testing Request

Please fill out the form below in order to gain access and request to participate in the pilot testing of the SIMPLE cases. For normal case use registration please click here.

SIMPLE case access and pilot testing request.

Institution
Address 1
Address 2
City
State/Country
Zip
Telephone number
Student email domains (i.e.,@uci.edu)
Clerkship Director
Email
Is your institution interested in pilot testing SIMPLE?	Yes No
Does your institution currently subscribe to CLIPP?	Yes No