1. This form is not meant to capture your entire Schwartz Rounds Planning Committee, only those in certain leadership roles: Physician/Clinical Leader, Facilitator, Program Coordinator, Organizational Leader, and Billing Contact

2. This form can be used to add or update up to 6 team members. Please feel free to submit and reuse the form as many times as you need to.

3. Questions? Please contact us at membership@theschwartzcenter.org