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* 1. What is your name (first name and last name)? Please provide your full name so we can send you an invitation to the Palliative Care Event.

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* 2. Where do you practice (clinic name)?

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* 3. Please select the palliative care (adult) topics you would like to receive further training/education on:

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* 4. What factors will affect your decision to attend a palliative care education session?

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* 5. Where is your preferred general location?

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* 6. Which type of training would you prefer:

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* 7. Would you like an in-practice demo on HealthPathways Melbourne, focusing on the suite of palliative care clinical and referral pathways?

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