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January 2024 HIPAA Training Registration
HIPAA Training Registration
January 5th, 2024
10:00 am - 11:00 am
Zoom online
Please register by January 3, 2024
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1.
What is your first name?
(Required.)
*
2.
What is your last name?
(Required.)
*
3.
What is your email address?
(Required.)
*
4.
What is your phone number?
(Required.)
5.
What is your address?
Address
Apt/Suite
City
State
Zip Code
6.
What is your Organization/Agency name?
7.
Did you complete the Community Health Worker training?
Yes
No
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