Name      Degree(s)

Email address

Mailing address

Telephone number (work)

Telephone number (home)

Telephone number (cell)

Academic title, if any. If you are a professor,

please specify what you are a professor of

Professional specialty, if any

Board certification(s)

Area(s) of expertise or special interest

Are you interested in:

Reviewing web sites: Yes No Not sure

Answering health-related questions: Yes No Not Sure

Writing one-paragraph book reviews: Yes No Not sure

Other (specify)

Our various projects can involve anywhere from a few minutes per month to a several hours per week. Approximately how much time can you offer?

Per week Per month

Which Web sites do you believe are the best ones for the general public in your specialty or area of interest?

Which Web sites do you believe are the comprehensive health-related sites for the general public?

Which books do you believe are the best ones for the general public in your specialty or area of interest?

What other health-related books do you believe are among the best?

Please tell us about yourself and what interests you in this project.

Other Comments?