To register for the 2016 Department of Psychiatry Research Day, please complete this form and email it to Frances Patrick at no later than June 1, 2016. She will also be happy to answer any questions you have regarding this event.

General Information
First Name: / Last Name, Degree(s):
Position Title: / Program:
Email Address: / Telephone Number:
Research Day Abstract Booklet Preference
(Check all that apply):eB0oklet (Sent by email prior to Research Day)  Hard copy of booklet (Pick up onsite on June 9th)
Lunch Selections
All registrants will receive a boxed lunch (consisting of a sandwich OR salad, a bag of chips, fresh fruit, a cookie and a drink).
Please select one of the following options and put an “X” next to your lunch choice.
 Roast Beef & Cheddar Sandwich /  Turkey & Swiss Sandwich /  Marinated Vegetables & Lettuce
Salad /  Chicken Caesar
Salad
Roundtable Discussions
If you wish to participate in a roundtable discussion during the lunch hour, you must register in advance by ranking you preferences below and receive an email confirmation of your roundtable assignment.
You will receive an email from our office by June 6, 2016 regarding the status of their request and – if assigned to a roundtable – details regarding your assignment. We will do our best to accommodate your request, but please note seating is limited to 9 participants at each roundtable. / Mark your top THREE preferred sessions below using #1, #2, and #3
Do not use checkmarks.
Roundtable #1
Facilitators: / Integration of Multimodal Neuroimaging Methods
Howard Aizenstein, MD, PhD and Dean Salisbury, PhD
Roundtable #2
Facilitators: / Taking the Next Step: Academic Promotion and Career Development
Sue Beers, PhD and Lori Zippay
Roundtable #3
Facilitator: / Statistical Consultation in Research: How to Get It and How to Use it
Meredith Lotz Wallace, PhD
Roundtable #4
Facilitators: / Research Opportunities: Health Disparities in Psychiatric Illness
Martica Hall, PhD and Alison Hipwell, PhD
Roundtable #5
Facilitators: / Fostering Creativity and Innovation in Research
Karen Matthews, PhD and Susanne Ahmari, MD, PhD
Roundtable #6
Facilitators: / Interventions Research in an Era of Neural Mechanisms
Daniel Buysse, MD and Jordan Karp, MD
Roundtable #7
Facilitators: / Work Life Balance: Finding it and Maintaining It
William Klunk, MD, PhD and Tina Goldstein, PhD
Roundtable #8
Facilitators: / Building and Leading a Research Group
Vishwajit Nimgaonkar, MD, PhD and Stephanie Stepp, PhD
Roundtable #9
Facilitators: / Cross Discipline Collaboration: Getting It Started
Brooke Molina, PhD and Cecile Ladouceur, PhD