Registration | Fall 2017 Regional Meeting | Worksites - Healthcare

Making it Better:  Fall 2017 Regional Meeting 

NOTE: Please have registrant answer the survey questions!

 

First Name

Last Name

Organization

Email address

Phone number

Which Regional Meeting do you plan to attend?

1. Oct. 5 - Southeast; Minnesota Department of Health District Office - Rochester, 18 Wood Lake Dr. SE, Rochester
2. Oct. 12 - Northwest; Minnesota Department of Health District Office - Bemidji, 7055th St NW, Suite A, Bemidji
3. Oct. 17 -  Metro; Northern Service Center (Rooms 110A and 110B), One Mendota Rd. W., West St.Paul
4. Oct. 19 - Northeast; Duluth Public Safety Building, (Training Rm), 2030 N Arlington Ave, Duluth
5. Oct. 24 - Central; St. Joseph Government Center, 75 Callaway St. E, St. Joseph
6. Nov. 2 - Southwest; Redwood Falls Public Library, 509 S Lincoln St., Redwood Falls

Would you like to speak with your community specialist?

1. No
2. Yes, regarding Please specify

What time works best to meet with your community specialist?

1. Over the lunch hour  (11:30 a.m. - 12:30 p.m.) - if choosing this time please make sure to bring a lunch
2. At the end of the day (after 3:30 p.m.)

What sector do you represent?

1. Public health (SHIP)
2. Tribal SHIP
3. Other MDH grantees
4. Other (please describe)Please specify

How long have you worked on SHIP initiatives?

1. Less than 1 year
2. 1-2 years
3. 3+ years

Healthcare Strategy
What to Bring: 
• Come prepared to discuss solutions developed to overcome barriers
• Please create a portfolio of youraccomplishments in a format easily shared with others.
(Examples: 3 ringbinder, file folder. Portfolios can include brochures that you’ve usedsuccessfully, articles, newsletters, local media, tools and templates that youhave either found and used or created.)

Is there any specific question(s) you would like addressed at the Regional Meeting?

What would you like to gain from the Regional Meeting?