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* 1. About You

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* 2. About You- please indicate your Role (at your hospital/institution/ agency

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* 3. About Your Hospital/Institution

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* 4. Please list any other hospitals or sites your represent:

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* 5. Would you like to be added to the Florida Stroke Registry listserv?

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* 6. Would you like to be considered to have access to the "for hospitals only" section of the Florida Stroke Registry website? 

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