Brattleboro Memorial Hospital Decon First Receivers Training Application

Brattleboro Memorial Hospital Decon First Receivers Training Application
Overview: Brattleboro Memorial Hospital will be participating in a Decon eight hour first recievers training. Space is limited to xx participants and will be approved based on a tiered system. After submitting, you will receive a separate email communication from vhepc@allclearemg.com when you have been accepted to the course.

Date: xxday xx, 2025 from 8:00AM to 4:00PM ET.

Location: Brattleboro Memorial Hospital, 17 Belmont Ave, Brattleboro, VT 05301. Additional on-site instruction to come.

Please fill out the application form below in order to be considered to participate.
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Organization*
Job Title*
What is your role in decontamination? *
Should be Empty: