Graduate Student Directory Form

This form collects information from new and returning students in order to update the directory pages for PhD and DNP students. Your participation in the directory is voluntary. By filling out this form, you give your consent for the information to appear on this website. You may contact us at communications@son.wisc.edu to edit or to remove your information.

Name*
First Last
School of Nursing email address*
Is this a a directory update or a new entry?*
This form is designed for new directory entries. If you wish to update your current entry, enter "no changes" in fields that should stay the same.
- New entry
- Update
Credentials*
List your highest degree followed by licensures. Examples: MSN, RN; BSN, RN, OCN.
Education*
List the schools where you earned your previous degrees. For example, MSN, UW–Madison; BSN, The Catholic University of America.
Do you grant permission to use your photo for the website directory?*
- Yes
- No
Have you had a photo taken at the School of Nursing?*
The directory uses headshots, with your permission, taken by our school photographer.
- Yes
- No, but I have a photo session scheduled.
- No, and I would like to schedule a photo at the next available session.
LinkedIn or other website profile (optional)
Further information about your professional accomplishments, such as your public LinkedIn page, online resume/CV, or other public profile.
In which program are you a student?*
- PhD
- DNP
Program track*
For example, Adult/Gerontology Primary Care NP; Psychiatric Mental Health
Scholarly interests*
For example, "Creating opportunities for movement, slowing the onset and progression of dementia, eliminating health disparities in underserved populations"
Short description of your clinical experience*
For example, "Four years at University Hospital includes Inpatient Operating Room RN, Cardiothoracic, Heart and Lung Transplant Team; Nursing Education Coordinator, Adult Intraoperative; Nurse Specialist, Adult Intraoperative"
Your advanced practice goal and clinical interests*
For example, "To work with older home-based adults with complex healthcare needs, especially those in early-stage dementia. Clinical interests include home health, evidence-based practice, education, adult/gerontology, and health disparities."
Advisor name(s)*
List your advisor(s) in the School of Nursing.
Minor*
Enter "none" or "undecided" if unknown.
Research interests*
For example, "Practice change, evidence-based practice, systems-approach"
Practice experience and interests*
Please use the third person. For example, "[Your name] is currently the nursing program specialist and magnet program director at UW Health; past experiences include being the clinical content facilitator at the Center for Clinical Knowledge Management, UW Health, and a nurse clinician in the Clinical Research Unit at UW Health."
Dissertation title, if available
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