2023 LTC Resident to Staff Aggression: Prevention and Response (Live, Virtual)

Contact information

If you wish to register for live, virtual training please complete the questions below. All in-person trainings will be in Kansas.

The grant training is intended for employees of smaller organizations and organizations that are not government owned. Based on size and ownership of your employer, you may not be eligible for the training. After you complete the form, we may contact you for more information to determine eligibility.

This material was produced under grant number SH-39151-SH2 from the Occupational Safety and Health Administration, U.S. Department of Labor. It does not necessarily reflect the views or policies of the U.S. Department of Labor, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.

Question Title

* 1. Please provide your contact information:

Name *

Title *

Organization *

State/Province

Email Address *

Phone Number *

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* 2. If the contact person for follow-up communication is NOT the same as the person completing the survey, please enter the contact person's information below.

Name

Title

Email Address

Phone Number

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* 3. Does your employer employ more than 500 people nation-wide?

Yes

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* 4. Are you considered a local, state or federal government employee?

Yes

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* 5. Does your employer employ more than 250 people at your worksite?

Yes