Post-Stroke Mood Changes: Exploring Anxiety and Depression
Please note: Participant seats are limited. Submitting this form does not confirm your registration. An email will be shared to confirm your registration at a later date.
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1.
First Name
(Required.)
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2.
Last Name
(Required.)
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3.
Email address
(Required.)
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4.
Role
(Required.)
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5.
Workplace/Organization
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6.
Part of the continuum (e.g. acute, inpatient, outpatient, etc.)
(Required.)
7.
What percent of your time do you work in stroke care?
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8.
I have discussed and received approval for the time commitment required for this workshop with my Manager
(Required.)
Yes
No
9.
Please indicate any dietary restrictions