VCH/PHC Quality Improvement: 1-day Training Registration
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First Name *
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Last Name *
Your answer
Contact phone *
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Contact email *
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Other contact email
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Department (example: Emergency, Family Medicine) *
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Community Of Care *
Which 1-day training are you registering for? *
Are you a physician? If not, please list your discipline below (Nurse practitioner, QI specialist, Resident, Fellow) *
If you have any dietary restrictions, please list them here or type n/a for no restrictions. Comments? *
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