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Kentucky Heart Disease and Stroke Prevention (KHDSP) Task Force

Email Distribution List Registration

KHDSP Task Force Email Distribution List Registration, * denotes required field

Complete this registration if you would like to be added to the KHDSP Task Force Distribution List and start receiving HDSP related emails including: meeting invites, webinar information, and breaking state and federal news.

You may opt out at any time by sending an email to david.davis2@ky.gov, include "remove me from the KHDSP distribution list" in the subject line.

*1.I would like to be added to the KHDSP Task Force Distribution List.(Required.)

Yes

No

*2.KHDSP Task Force Member Information(Required.)

*First Name *

*Last Name *

Credentials e.g., MD, RN, MHA...

*Organization (please spell out completely) *

*Position/Title *

*Phone *

Extension (if applicable)

*Email Address *

Additional Contact Info, e.g., Cell or Alt Phone # (not required)

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