Please complete this survey so that our education program calendar will reflect the the specific needs of our chapter members.    The survey should not take more than 5 minutes.

Deadline:  Monday, March 31

All items with * are required fields.  
CHECK ALL BOXES THAT APPLY
Use TAB or MOUSE between fields; the ENTER key will submit the survey

Name *
Name
Preferred Phone *
Preferred Phone
In what type of facility do you work?
(Check all that apply)
What is your position
Technology (Surveillance technology, health informatics, information technology (IT) e.g.)
Infection Prevention and Control
Leadership and Program Management
Product innovation
Surveillance
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