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CVHG Policy Workshop Registration
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Location
Atlanta Metropolitan State College
Easley Conference Pavilion
Edwin Thompson Student Center Bldg.
#800, RED PARKING LOT.
1630 Metropolitan Parkway
Atlanta, GA 30310
Time
9am - 4:30pm
Full Name
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Your answer
Email Address
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Your answer
Phone Number
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Your answer
Are you a community health worker, or self-identify as such, and work in Georgia?
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Yes
No
Organization/Agency you work for:
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Your answer
Position/Title
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Your answer
Which workgroup would you like to participate in?
*
Senior Health
Maternal Health
Mental Health & Substance Abuse
Access to Transportation
Do you need enhanced accessibility supports for this training? If yes, please indicate the level of support below.
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Do you have any dietary requirements?
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None
Vegetarian
Vegan
Gluten-Free
Other:
How did you hear about this workshop? (Check all that apply.)
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Word of Mouth
Newsletter
Colleague
Social Media (Facebook, Twitter, Etc.)
Other:
Would you be interested in joining a listserv to support information sharing and coordination among state community health workers working to improve healthcare access?
Yes
No
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