Prospect Evaluation

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=90 BGCOLOR="#006699" TEXT="#080000" bgproperties="fixed" background="02c285a1erlcgo.png"> <div> <FONT SIZE="5" COLOR="#FFCC66" FACE="Arial" ><B>Durant Family Medicine Clinic</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="Durant Family Medicine Clinic"><B>home</B></A></div> <bR> <div> </div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" background="02ad2c00dkelyh.png"> <div> This web page will take you to form designed to gain input regarding prospective intern(s).</div> <bR> <div> Thank you in advance for taking the time to assist in the evaluation of potential interns.</div> <bR> </td> <td valign="top" height=390 width="100%" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Prospect Evaluation</I></div> <bR> <div> Click Here to Begin Evaluation</div> <div> <A HREF="http://fs19.formsite.com/DFMC/form455233466/index.html" TARGET="_top" TITLE="http://fs19.formsite.com/DFMC/form455233"> <img src="HTMLobj-701/aniGif.gif" border="0" align="bottom" width="130" height="111">  </A> </div> <bR> <div> Form will be emailed to:</div> <div>                   Greg Martens, D.O. (Program Director)</div> <div>                    Angie Pillars (Program Secretary)</div> <div>                   Terry Lee, D.O. (DME)</div> </td> </tr></table></body>