TO BE ANNOUNCED

Full Name

Email

Organization

City / State

Professional Title and Role

How would you best characterize your background (select all that apply)

Did you receive a “Save the Date” Notice? Who sent it to you?

What, if any, relevant pediatric mental health initiatives or programs are you involved in?

What specific topics or challenges in pediatric inpatient care are you most passionate about?

What do you hope to gain or contribute at the Summit?