Primary Care Concerns - August 15, 2023

Name*

First NameLast Name

E-mail*

Please confirm E-Mail.

example@example.com

Mobile Number (Optional)

Area CodePhone Number

Number of people attending:

How did you hear about this program:

Please choose the best attendance option for you

I will attend the program in personI am unable to attend in person and hope you will have a live stream option for meI am not sure if I can attend in person or online

Please note that at this time we plan on running the program in person at Adath Israel Congregation. Please check your email by Friday August 11 to confirm the format of the program.

Thank you for registering for Our Primary Care Concerns program on Tuesday, August 15 at 7:00 p.m.

We look forward to seeing you at Adath Israel.