Pre Arrival Form | Pediatrics Board Review

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Name(Required)

Nickname(Required)

Email (Please use the same email address that you typically use with all PBR communication and memberships)(Required)

Re-Enter Your Email(Required)

SUBJECT (Please write "PRE-Arrival Form" Below)(Required)

Mailing Address(Required)

In case we need to mail something to you for the course, what is the best mailing address. Keep in mind that it may arrive very close to the date of the course.

CONTACT: Please list an emergency contact, their best number, and your relationship..(Required)

What dates are you attending the live coaching course?(Required)

Cellphone Number(Required)

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Which hotel will you be staying at?

Required if this course is an in-person live course. Not required if this is an online live course.

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LEAVING: What time will you leave the HOTEL on Sunday?

Please assume that you'll need to leave at about 2.5 hours prior to your flight if you have a car to return. This may help us determine the order in which to have the one-on-one sessions. Required if this course is an in-person live course. Not required if this is an online live course.

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FLIGHT: What time is your flight?

Required if this course is an in-person live course. Not required if this is an online live course.

GRADUATED: When did you finish the training related to THIS exam?(Required)

If you are still in residency, please write your current PGY level.

NUMBER TAKEN: How many times have you ALREADY taken this exam?(Required)

If THIS is your first time, write "This is my first time."

LAST EXAM: What year was your last exam?(Required)

If this is your first time, write "Never taken."

YEAR & SCORES: List each YEAR you took the exam and the SCORE for each year.(Required)

For the ABP initial certification exam, passing is 180. If possible, please list ALL of your previous years and scores. If you are listing a different exam, please also list the passing score next to it in parenthesis.

LAST TIME: What materials did you use to study LAST TIME? Study guides, online courses, live courses, etc.(Required)

Today's Date

ACCOMPLISHED: What have you accomplished from your study plan so far?(Required)

PLAN: What is your study plan for this year?(Required)

Are you a member of the Online Test-Taking Strategies course?(Required)

WATCHED: If you ARE a member of the Online Test-Taking Strategies course, have you viewed all 5 of the "Question Processing" webinars? (Note: It is recommended for VIP bundle members to watch videos one through three)(Required)

If you're NOT a member, please type "I'm not a member" and briefly explain why you decided not to get this recommended resource.

CHALLENGES: What will it take to pass your boards? What challenges/decisions come to mind?(Required)

GOALS: What are your goals for the course?(Required)

SUPPORT: If available, what kind of added support would be of greatest help to you after the course?(Required)

SYMPTOMS: What kind of symptoms do you have?

For example, tachycardia, perspiration, nausea, diarrhea, loss of focus, thoughts of consequences, etc.

TRIGGERS: What triggers it?

For example, a single hard question, a series of hard questions, time left on the clock, or maybe you’re just not sure.

SYMPTOMS: What kind of symptoms do you have?

For example, tachycardia, perspiration, nausea, diarrhea, troubling thoughts of consequences, etc.

WHEN do you have it before the exam?

For example, the days leading up to the exam, the night before, the morning of, etc.

TRIGGERS: What triggers the anxiety?

For example, talking about the exam, studying, proximity to the exam, or not meeting your target study goals.

WHEN/WHAT: When do those symptoms come on and what symptoms do you have at those times?

For example, maybe you have symptoms in the days leading up to the exam, the night before the exam, and/or during the exam. And maybe you have tachycardia, perspiration, nausea, diarrhea, loss of focus DURING the exam, but insomnia the night before, or distracting thoughts of consequences in the days leading up to the exam, etc.

TRIGGERS: What triggers the anxiety?

For example, general fear of failing, a single hard question, a series of hard questions, time left on the clock, etc.

LIVE Coaching Pre-Arrival Form - Questionnaire

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