Long COVID Conference
Helping the Primary Care Provider with Management and Treatment
Register for this in-person information session
*
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please list the type of Medical Insurance you have:
*
Private (PPO)
HMO
Medical
No Insurance
Kaiser
Medi-Cal
Other
How familiar is your Primary Care Physician with Long COVID?
Not familiar
Moderately familiar
Extremely familiar
On a scale of 1 to 5, as a Patient:
*
Not familiar
Slightly familiar
Moderately familiar
Very familiar
Extremely familiar
How familiar are you with Long COVID?
Do you have any suggestions for future sessions?
Submit
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