Form # FMA/AARPOINTP-001 / 07.05 (Rev. 10.03.14) White – Health Information Management Department Yellow – Patient Reviewed 09/13 Authorization for Audio Recordings, Photography, or Other Images for Non-Treatment Purposes I hereby authorize the at (insert department name) UT Southwestern Medical Center to make audio recordings or to take photographs, videotape, or digital images of me (“Images”). I understand that  UT Southwestern may use and release my images to the general public for

Date this form completed PERSONAL DATA Last Name First Name Middle Initial Permanent Address: City State Zip Code Mobile Telephone Work Telephone E-mail Address Place of Birth Date of Birth Country of Citizenship If not US, what is your visa status: Permanent Resident J1: H1: Other: Issue Date: Expiration Date: EDUCATION College Medical School Graduate School NAME OF INSTITUTION LOCATION DATES OF ATTENDANCE DEGREE AWARDED Current Position Nominating Chairperson Clinical

Obesity Alliance Conferences 2007 The UT Southwestern Obesity Alliance's weekly conferences on metabolism, nutrition, and obesity are held at noon on Thursdays (Y6.224). The conferences are sponsored by the Task Force for Obesity Research (TORS). December 27, 2007- rescheduled October 25, 2007 Vinaya Simha, M.D. "Metabolic Consequences of Bariatric Surgery." October 18, 2007 Jeffrey Zigman, MD, PhD Ghrelin and motived behaviors. October 11, 2007 Mark Drazner, MD

Obesity Alliance Conferences 2009 The UT Southwestern Obesity Alliance's weekly conferences on metabolism, nutrition, and obesity are held at noon on Thursdays (Y6.224). The conferences are sponsored by the Task Force for Obesity Research (TORS). Thursday, December 17, 2009 Richard Auchus, M.D., Ph.D. "Fat Wars II: Attack of the Steroids" Thursday, December 10, 2009 Stephen H Caldwell, M.D. "Perspectives on NASH" Thursday, December 03, 2009 Yong-Xu Wang, Ph.D. "A

Obesity  Alliance  2012   The  UT  Southwestern  Obesity  Alliance's  weekly  conferences  on  metabolism,   nutrition,  and  obesity  are  held  at  noon  every  Thursday  in  the  Green  Building   (Y6.224).  The  Task  Force  for  Obesity  Research  (TORS)  sponsors  the  weekly   conference.     • December  13,  2012   Philipp  Scherer,  Ph.D.   Professor  and  Director,  Touchstone  Center

Obesity Alliance Conferences 2008 The UT Southwestern Obesity Alliance's weekly conferences on metabolism, nutrition, and obesity are held at noon on Thursdays (Y6.224). The conferences are sponsored by the Task Force for Obesity Research (TORS). • Thursday, December 18, 2008* Robert D. Toto, M.D. "Microalbuminuria, Obesity and Cardiovascular Disease Risk" • Thursday, December 11, 2008* Jean J. Zhao, Ph.D. "Isoforms of PI3K in cancer and metabolism" • Thursday, December 4, 2008

Obesity Alliance Archives 2013 The  UT  Southwestern  Obesity Alliance's weekly conferences  on  metabolism,   nutrition,  and  obesity  are  held  at  noon  every  Thursday  in  the  Green  Building   (Y6.224).  The    Task Force for Obesity Research (TORS)  sponsors  the  weekly   conference.   • January 10, 2013 Bruce Beutler, M.D. Director, Center for the Genetics of Host Defense "Creating IBD-like diseases in mice through random

“ ” ” MISSION The Community Action Research Track (CART) offers medical students opportunities to promote healthier behaviors, address key health issues within communities, and engage in service-learning activities with the underserved. Students participate in community-based service learning experiences and didactic sessions designed to improve their skills in community medicine. Through these experiences, they contribute to improving health in the underserved

Community Action Research Track (CART) Department of Family and Community Medicine Community Health CART Program Overview The Community Action Research Track (CART) is an innovative response to the need for integrating Community Based Participatory Research (CBPR), population medicine, health promotion/disease prevention and the social determinants of health into the medical school curriculum. Students enrolled in CART participate in a coordinated

The Collaborative for Advanced Clinical Techniques in UltraSound (CACTUS) constitutes a group of like-minded physicians, scientists, and technical experts dedicated to the advancement of clinical ultrasound imaging and image-guided intervention