Regional Workshops Registration 2016

Choose which Regional Workshop you will be attending.

Please enter the following information to register for our Stroke/STEMI Regional Workshops.

Name (First and Last):

Credentials:

Job Title:

Hospital/Agency/Affiliation:

City:

Email address:

Re-enter your Email Address:

Phone Number:

Special Accommodations: dietary restrictions, handicapped-accessible, etc.

Please choose your area of employment.

Please indicate your area(s) of interest:

Please check the box below if you would like to be added to our listserv for more communications about stroke and STEMI in Minnesota.

Minnesota Department of Health