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Stroke and STEMI Online Education - APEX
Hospital Teams
*
1.
What is the
NAME
of your organization?
(Required.)
*
2.
What is your
FULL ADDRESS
? (street number, street name, city, state, zip code)
(Required.)
*
3.
What is the
FULL NAME
and
CREDENTIALS (i.e. RN, MD)
of the administrator you would like to be assigned for your web-based
Heart Attack
education system? This administrator will be responsible for assigning access to the system to staff at the hospital (nurses/physicians).
(Required.)
*
4.
What is the
EMAIL ADDRESS
of the administrator you would like to be assigned for your web-based
Heart Attack
education system?
(Required.)
5.
What is the
PHONE NUMBER
of the administrator you would like to be assigned for your web-based Heart Attack education system?
