ACHE WFC wants your input! Please complete the short survey below to provide input on events, topics, and more.

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* 1. Your Name

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* 2. Are you or someone you know interested in speaking at an ACHE WFC event? Please fill out the contact information below:

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* 3. Which event type is your preference? Please select all that apply.

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* 4. Which days are best for you to attend events? Please select all that apply.

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* 5. What times are best for you to attend events? Please select all that apply.

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* 6. What kind of events are you looking to engage in? Please select all that apply.

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* 7. What healthcare topics are you interested in learning more about? Please select all that apply.

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* 8. Are you interested in volunteering? Fill out the contact information below:

Thank You!

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