REGISTRATION FOR TREAT ME - Block Seven: In-Person Half Day - June 22, 2023

Registration for June 22nd Learning Session

We will hold this in-person half day workshop/seminar at Maple Hill Farm in Hallowell, Maine. Hallowell is just minutes from Augusta and easy to reach from the Maine Turnpike - exit 109.

There is NO CHARGE to attend - but we ask that you let us know if you register and are unable to attend so we don't pay for your meals.

This is open to ALL child health providers who interact with patients. Those participating in the TREAT ME Learning Collaborative AND those who are not part of the formal collaborative.

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* 1. Please provide the following information to register!

Full Name

Credentials

Organization

Email Address

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* 2. Which of these settings best describes your practice environment?

Primary Care Office

Emergency Room or Urgent Care Setting

Behavioral Health Facility

School or SBHC Setting

Other (please specify)

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* 3. Have you been an ongoing participant in the collaborative?

Yes

No - and I would like CME for this program.

No - and I am a pediatrician and would like CME and MOC for this program.

No - and I would like a certificate of attendance for this program.

Comments:

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* 4. Is there anything in particular you are hoping to learn from this session?

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* 5. Please share your dietary/meal preferences...

No special requirements

Vegetarian

Vegan

Any allergies?