I am interested in becoming an active GME Initiative member.

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* 1. Your Contact information

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* 2. Are you interested in becoming involved in the following?

  Yes No  Maybe, please provide additional information
States Initiatives Committee
Legislative/Policy Committee
General GMEI Consortium

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* 3. Please share the contact information of anyone you know who might be interested in participating in the GME Initiative

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* 4. Please share the contact information of anyone you know who might be interested in participating in the GME Initiative

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* 5. Please share the contact information of anyone you know who might be interested in participating in the GME Initiative

Questions?  Please contact:
Julie Herzog
Director of Operation and Programs

Colorado Institute of Family Medicine
julie.herzog@cofmr.org

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