Video Submission for YouTube Video Submission for YouTube Uploader’s Name * Uploader’s Title * Uploader’s Email * Uploader’s Division/Group * Allergy and ImmunologyBone and Mineral DiseasesCardiology/Cardiovascular DiseasesDermatologyEndocrinology/Metabolism/Lipid ResearchGastroenterologyGeneral Medicine & GeriatricsHematologyHospital MedicineInfectious DiseasesNephrologyNutritional Science & Obesity MedicineOncologyPalliative MedicinePulmonary and Critical Care MedicineRheumatologyVeterans AffairsOther Uploader's Division/Group Video Title * Recording Date * Speaker’s Name * Speaker's Name First First Middle initial Middle initial Last Last Speaker’s Degree(s) * Speaker’s Title(s) * Speaker’s Institution/Department/Division * Speaker’s Web Bio Video Description * Permission for recording to be placed on DOM’s YouTube channel * Yes No Please keep on file all signed Media release forms for non-WashU speakers Has this video been watch by you to make sure there are NO HIPAA protocols being broken? * Yes No Captcha Submit If you are human, leave this field blank. Upload Video Files (mp4) Here (password protected)