Connect with CCHF
Are you a student who'd like to know more about CCHF?
Interested in learning about missional healthcare to the underserved?
Provide the info requested below and we'll be in touch!
First Name
Last Name
Email
CCHF desires to be a people of "every tongue, tribe and nation." (Rev. 5:9-10)
How do you self-identify?
Please select...
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African
Native Hawaiian or Other Pacific Islander
White
Multi-Racial/Multi-Ethnic
Some other race, ethnicity or origin
Prefer not to answer
School or Residency
Other School or Residency not on the list:
Expected Graduation Date
XX/XX/XXXX month/day/year
Where are you in your training?
Please select...
Resident
Graduate Student
College Student
Alumni
Gap Year/Intern
Degree Being Pursued
Please select...
BA/BS
Clinical Psych
DDS
DO
DPT
MBA
MD
MPH
MSW
NP
OT
PA
PharmD
PhD
Other
What are your goals as a medical professional?
Residency Specialty
Please select...
Emergency Medicine
Family Practice
General Surgery
Neurology
OB/GYN
Pediatrics
Psychiatry
If applicable, choose your current, or desired, residency specialty.
Other Residency Specialty
What are you looking for in a residency program?
How did you hear about CCHF
Please select...
A friend/colleague told me
Internet Search
CMDA
A different campus fellowship
Other, please specify
How did you hear about CCHF, other (specify here)
Have you been involved with CCHF in the Past?
This is my first experience
Virtual Meetings
CCHF National Conference
CCHF Conference Volunteer Scholarship Recipient
I receive emails from CCHF
I have spent time at a CCHF Clinic
Other, specify below
Check all that apply
Other Involvement
Are you currently involved with a Christian fellowship at your school?
Please select...
CMDA
MCO
InterVarsity
Church Bible Study
Other
Other Christian fellowship involvement?
CCHF wants to be a part of your journey. Leave any questions or comments here, along with any details you would like to share, we love details!
CCHF would like to occasionally contact you. Things we send via email are quarterly newsletters, conference information, student events and general encouragement.
Be sure to add
info@cchfmail.org
so you don’t miss anything!
Are you currently in training
Please select...
Yes
No
Choice C
Contact Information