Thanks for taking the time to complete this form and being a part of this cause. 
Your information will be posted to the NRHA RME website in a timely manner.
    
Name of Residency:
Location:
Contact Person:
       
Allopathic     Osteopathic

Which model does your residency fit into? 

  I.  Primary location in a metropolitan area with either required or optional away rotations at a distant rural site;
 II.  Primary location in a metropolitan area with a rural satellite clinic that serves as the resident's family practice center;
III.  Primary location in a metropolitan area with a rural training tract (RTT) where the resident's spends their first year in the primary site, and the last 2 years in a rural community;
IV.  Primary location in a non-metropolitan area
V.  Primary location in a non-metropolitan area with rural satellite

Do you have a rural fellowship?    Yes    No

If you have a webpage, please provide us with the main url:  

Description of your residencies rural components:

   If you have an area on your website that discusses your rural programs, we would appreciate the URL.  If we
    have the URL, you can continually update and change as needed.   This will keep the website current.
    Rural Programs URL:   

    If you do not have a website, we will post the description of your school's rural emphasis/mission and each
    year, ask the contact person if this is still correct.
    Sending Description       Contact Person:

Rural Curriculum

    If your rural curriculum is on the web we would appreciate your URL.  If you curriculum is not on the web,
    please submit your curriculum each year.
    Rural Curriculum URL:   

    Do we have permission to publish and collate your curriculum on the NRHA RME web area:
    Yes     No

Rural Cases:

    If you have rural cases and would like to share your URL's or paper cases, it is very much appreciated.  The
    source of all cases will be prominently displayed.
    Rural Cases URL:   

Rural Lectures:

    If have developed rural lectures and would like to share your URL's or PowerPoint lectures, handouts,
    speaker notes, it will be very much appreciated.  The source of all lectures will be acknowledged by any user.
    Rural lectures:           

    PowerPoint lectures:   

As this is a continual work in progress, please remember this website for future submissions.
The cooperative sharing will go far to further rural medicine.

Paper Submissions:

National Rural Health Association
One West Armour Blvd. - Suite 203
Kansas City, Missouri 64111-2087

or

 Debra M. Phillips, M.D.
Chair, Web Curriculum Committee
C/O Quincy Family Practice Center
612 North 11th Street, Suite B
Quincy, IL  62301