1. DISASTER TRIAGE TRAIN-THE-TRAINER COURSE
Name:
Title:
Organization:
Address:
Phone:
___________________________________
Signature
Check Session Attending:
February 11, 2014 – 9:00 – Nicholas Noyes Hospital, Conference Room D
REGISTRATION DEADLINE: FEBRUARY 4, 2014
March 18, 2014 – 1:00 – St. James Mercy Hospital, Memorial Conference Room
REGISTRATION DEADLINE: MARCH 11, 2014
March 25, 2014 – 9:00 – Unity Hospital, Education Center
REGISTRATION DEADLINE: MARCH 18, 2014
INTENDED AUDIENCE: Physicians, Nursing, NP/PAs, EMS, Fire, Police, Pharmacists, Allied Health Professionals, Medical/Nursing Students, Anyone identified to do disaster triage in their agency
TO REGISTER , FAX or MAIL SIGNED REGISTRATION FORM TO:
EILEEN SPEZIO
601 ELMWOOD AVE., BOX 612
ROCHESTER, NY 14642
FAX:
PHONE:
An confirmation will be sent within three days of receipt of registration.
If you have not received confirmation by then, please call Eileen Spezio at contact information above.