Buprenorphine Waiver Training
DATE: 12/14/18
TIME: 8:00 am - 5:30 pm (including an hour off for lunch)
COST: FREE
LUNCH: not provided
 
LOCATION:
Einstein Healthcare Network
Korman Building Basement
Emergency Medicine Conference, Room B-16-20
5501 Old York Rd, Philadelphia, PA 19141

- Registration is limited to 50 participants


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PARTICIPANT INFORMATION:
First Name *
Last Name *
Email Address *
Organization / Affiliation / Company - Indicate what organization you work for or represent *
Title - Indicate Profession / Occupation *
City *
State *
Zipcode *
Special Needs *
Hearing impaired, wheel chair accessible, etc.
Required
Phone Number *
Additional Information
The Central East is requesting your participation in conducting random interviews with Supervisors to gather information about the organization or department. If selected, we will notify your supervisor that an employee has attended one of our training.
Supervisor Name
Supervisor Email
Supervisor Contact Number
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