Create a Profile

 

By creating a profile, you will be able to access features on this website that are only accessible to registered users: submitting a proposal, purchasing conference tickets, connecting with other attendees, and more. All of these features will be accessible from "My Dashboard".

Please do not create another profile if you already have one from the 2017 Chicago conference. If, by chance, you do create a second profile, we will keep the new one and delete the old one.

 Please fill out all fields on this form to the best of your ability. IM4US uses the information you share in the following ways:

  • Name badges: first name, last name, organization, city and state will appear on your name badge. 
  • CME program: We intend to offer a continuing medical education program at this conference. ACCME requires first name, last name, mailing address, and degree/license suffix (if applicable) for all attendees, whether or not they participate in this program. 
  • Your public profile available to other conference attendees will include your profile photo, first name, last name, organization, professional identification, bio, interests, city, and state. Contact information will be kept hidden.
  • Demographic Information: we use this data to measure our effectiveness for providing a conference experience that represents our values and the diverse communities we serve. 

Thank you for participating in our conference!

First Name*
Last Name*
Email*
Password *
Confirm Password*
Employer or School*
If employed, enter the name of your employer. If student, please enter name of school. If neither apply, enter n/a. Employer or School name will appear on your name badge.
Job Title*
Enter your job title if employed. If student, list your student type. If not employed, please enter n/a.
Degree/License Suffix
Please list each degree/license suffix in its official abbreviated form, separating each with a comma: MD, PhD, ND, NP, etc. Please do not enter any other information in this box. Leave blank if this question does not apply.
Personal/Alternate Email
Many institutions have strict email protocols that prevent certain emails from going through. Please enter a personal email or alternate email here in case that happens.
Daytime Phone*
Evening Phone*
Mobile Phone Number
If you would like to receive SMS notifications/reminders please enter a mobile number including country code, area code and phone number. Example: +14158904641.
Mailing Address 1*
Mailing Address 2
City*
State*
Please enter 2-letter abbreviation
Zip/Postal Code*
Room & Ride Sharing

If you're interested in sharing a room or carpooling with someone, please tick the boxes below. You can see others who have the same interests by visiting your attendee Dashboard and clicking the "Matchmaking" option under your profile photo.



Interests
What shared interests would you like to connect with other attendees about? Could be personal, professional, or policy/advocacy related. This will appear on your profile for other attendees to see.
(Up to 50 Words)
Lodging preference*
Please choose the answer that best describes your lodging needs.
Have you attended an IM4US conference before?*
Presenter or Attendee Bio
Please enter a brief bio here to share with conference attendees for presentation or networking purposes. You may use names and identifiers. 150 words max.
(Up to 150 Words)
Demographic Information
A core goal of IM4US is to reflect the spectrum of practitioners who work to make integrative healthcare accessible to the underserved, and the diverse communities whom they serve. We seek to manifest this diversity in our organization's conference attendance, membership, and leadership. Please assist us by sharing more about yourself through the following questions to help us track our inclusiveness.
Gender Identification*
Race/Ethnicity*









Professional Identification*
If your profession is not listed, please email info@im4us.org and we will add it. This information will appear in your public profile for other conference attendees to see.






























Terms and Conditions and Video Release*
I have read and agree to the Terms & Conditions and Video Release
Calendar

Our Event Apps

Using the event app, attendees can:

  • Update their profile
  • Manage their personal schedule and check-in to sessions
  • Set up 1-to-1 meetings with fellow attendees
  • View sponsors and exhibitors and their representatives, send requests to get their contact details
  • Engage in discussions on the forum

Guests can:
  • Sign up using Facebook or registration form
  • View attendees and speakers, and their publicly available details including submitted abstracts and checked-in sessions.