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1. Participant details

Please complete all the questions in order to ensure the ongoing quality of the Telehealth Virtual Education Program and to ensure that we provide topics of interest. Please note that evaluation forms must be completed to receive a certificate of attendance.

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* 1. How did you view this presentation

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* 2. Name of your hospital/facility

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* 3. LHD

 
Your Local Health District

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* 4. Name to appear on Attendance Certificate

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* 5. Please enter your email address

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* 6. Discipline

 
Your discipline
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