Provider Profile | Newman Regional Health

The information you provide below will be used to develop a profile page on the Newman Regional Health, Google Business and other web-based directory services. Each profile is unique and will have different pieces of information

Here is a link to samples of the page design and intended layout and content.
https://www.newmanrh.org/timothyharris/

https://www.newmanrh.org/ryanlasota

Social Media – If you want your social media pages connected to your profile, there is a space below on the form.
Two examples:
https://www.facebook.com/alana.fearey
https://www.linkedin.com/in/rogerawill/

Please fill out your form below and if the team working on your profile has any questions they will reach out to you on your NEWMANRH.ORG email unless you specify a different address or contact method.

Provider Profile Information form

Name
First Middle Last post-nominal titles or designatory letters
Email*
Will ONLY be used by staff and not published on the website or directories
Professional Profile*
Please include education, advanced education, honors, residency and other specialized training. For an example please see http://www.newmanrh.org/drhurley
Personal Profile
Please include any information you would like to share about yourself, your family, your personal outlook on care, your personal motivations - anything you would like to include on the profile where readers will look to decide that you are the right person to seek help from.
Procedures and Conditions treated*
Please provide as complete a list that is possible with in reason. Our goal is to provide search engines results when a local person searched for a specific treatment or condition.
Credentials and Education*
Example: University of South Dakota, Bachelor of Science, Biology, Phi Sigma Honor Society
Certifications*
Example: American Board of Internal Medicine, Certified in Cardiovascular Disease ad Interventional Cardiology, Internal Medicine
Licensure*
Example: KS State Medical License
Awards, Honors & Recognitions
Example: Fellow, Society for Vascular Medicine
Languages Spoken
Special instructions to web team.
Please let us know about any concerns or special requests.
Photos you would like included on your profile
We will use the current head and shoulder photograph of you that we have on the website, this is for additional photographs you may want included.
Drop files here or

Max. file size: 50 MB.
SOCIAL MEDIA
If you want your social media connections to be shared, please list the name and identifier on the account. Example: https://www.linkedin.com/in/rogerawill/

Save and Continue Later

Provider Profile Information form

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