Name_________________________________________________________
Phone_________________________________________________________
Address_______________________________________________________
______________________________________________________________
E-mail_________________________________________________________
Institutional Affiliation_____________________________________________
Specialty_______________________________________________________
Clinical Interests_________________________________________________
_______________________________________________________________
Languages Spoken_______________________________________________
(other than native)
Prior trips/countries_______________________________________________
_______________________________________________________________
_______________________________________________________________
Contacts in Country_______________________________________________
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Please e-mail additional thoughts/suggestions to Dr. Duffy:
fjduffy@sbcglobal.net
Related Organizations and Links
Doctors Without Borders/Medecins Sans Frontiers www.doctorswithoutborders.org
Interplast www.interplast.org
Operation Smile www.operationsmile.org
Physicians for Peace www.physiciansforpeace.org
Rotaplast International www.rotaplast.org
Smile Train www.smiletrain.org
Volunteers in Plastic Surgery/VIPS www.plasticsurgery.org/public/VIPS