Thanks in you interest in becoming a member of the Southeastern Region's State Medical Assistance Team and Medical Reserve Corp.  This short survey will start the registration process.  Once your profile is created, you will be emailed your username and temporary password.  You will also be contacted regarding membership.  

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* USER INFORMATION:

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* EMAIL ADDRESS:

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* PHONE/PAGER/TEXT:

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* What is your profession, paid and/or volunteer?

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