Spring 2020

Please register for the Geriatric Healthcare Series Spring 2020 by filling out this form. There will not be a confirmation email, but you will receive weekly emails of each coming lecture from your state coordinator.

Should you have any problems filling out this form, please email nwgwec@uw.edu. 

Question Title

* 1. What entity are you participating from?

Question Title

* 2. What's your name (first and last)?

Question Title

* 3. Your credentials / degree(s) (eg: RN, DO, ARNP)?

Question Title

* 4. Name of your current employer:

Question Title

* 5. What's your current health profession? (based on funding agency categories, please choose the one that best fits your profession)

Question Title

* 6. What's your email address?

Question Title

* 7. Please select if any of the following is true (mark all that apply):

Question Title

* 8. Do you currently work in a (mark all that apply):

T