Older Adults and Social Determinants of Health

Registration Form

Please complete this registration form, on the second page of the form click the link that says 'Click Here' to access the webinar. Please refer to the Rhode Island Geriatric Education Center's website for directions to receive continuing education credits. If you have any questions please email rigec@etal.uri.edu or call 401-874-5311. Thank you!

Question Title

* 1. First Name

Question Title

* 2. Last Name

Question Title

* 3. Credentials

Question Title

* 4. Email:

Question Title

* 5. Organization

Question Title

* 6. State

Question Title

* 7. Trainee Type:

Professional / Provider

Student or Clinical Trainee

Other (please specify)

Question Title

* 8. Your Professional Discipline:

Allied Health

Medicine

Nursing

Pharmacy

Psychology

Social Work

N/A

Other (please specify)

Question Title

* 9. Do you wish to be notified about future program offerings?

Yes