Thank you for your interest in attending a Patient-centered Counseling Training hosted by the Oregon Health Authority Transformation Center. Please answer these questions to be added to the waitlist. If a spot opens up for the location you indicate, we'll use your answers to register you.

These questions also serve as the CME pre-test.

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* 1. Your name

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* 2. Email address

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* 3. Job title

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* 4. Organization

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* 5. Which training are you hoping to attend?

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* 6. Please list your credentials (for CME purposes)

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* 7. Will you be claiming continuing medical education credits for this training?

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* 8. Lunch will be provided at this training. Do you have any dietary restrictions?

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* 9. Do you need an accessibility accommodation to fully participate in this event? Some examples of accommodations include: American Sign Language, language interpretation, audio enhancement, captioning, and large print text.

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* 10. What are you hoping to learn from this training?

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* 11. Which topics are you most interested in developing patient-centered counseling skills around? (check all that apply)

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* 12. Which populations are you most interested in developing patient-centered counseling skills for? (check all that apply)

 
 50% of survey complete.
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