HealthCare Synergy Educational Workshop

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* 1. Contact Information

Full Name

Agency/Organization

Phone Number

Email

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* 2. What would you like to learn about

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* 3. Where would you be willing to travel?

Burbank/Glendale Area

Orange County - Anaheim Area

San Fernando Valley

Other

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* 4. Would you prefer a COVID-Friendly virtual workshop?

Yes

No

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* 5. What days of the week would be best for you?

Monday

Tuesday

Wednesday

Thursday

Friday