RHA Didactic Training Interest Form

RHA Didactic Training Interest Form
Name*

First NameLast Name
Company*
Title*
Email*
example@example.com
Phone*
Please enter a valid phone number.
Are you or your company a member of Renal Healthcare Association?*

YesNoUnsure
Are you interested in the RHA Didactic Training program for yourself or a colleague?*

I would like to register myselfI would like more information for my dialysis center, unit new hires, or unit staff
Which of the following upcoming cohorts are you interested in? Select all that apply.*

November 16 - December 7 - 10:30am-1:30pm ETNovember 30 - December 21 - 2:00pm-5:00pm ETDecember 14 - January 4 - 10:30am-1:30pm ET
How did you learn about this program?*
Should be Empty: