UC Berkeley Public Health Informatics Interest Form

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Welcome to the Public Health Informatics Interest Form!

If you are interested in receiving more information about the certificate program and courses being offered through the California Consortium of Public Health, Informatics, and Technology, please fill out this form.

We will connect with you and send you emails with more opportunities to stay connected with CCPHIT! We look forward to meeting with you soon!

Contact information: PHinformatics@berkeley.edu

Website information: Click here.

First and Last Name *

Contact information:

Please enter your email address.

Contact information:

Please enter your phone number.

Best time to reach you: *

Morning

Afternoon

Evening

Not Applicable

Weekday

Weekend

Current status (Select One): *

Please enter your home campus:

UC Berkeley

A different University of California (UC) campus

California State University, Long Beach

California State University, East Bay

A different California State University (CSU) campus

Community College

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Thank you so much for your time! We will connect with you and send you emails with more opportunities to stay connected with CCPHIT!

Public Health Information, UC Berkeley team.

PHinformatics@berkeley.edu

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