Blue Ridge Area Health Education Center Continuing Education Survey
RequiredRequired Question(s)
Progress: 
 
1. Continuing Education Needs Assessment
 
Blue Ridge Area Health Education Center (blueridgeahec.org) is a community non-profit devoted to recruiting, training, and retaining health care professionals in our 20-county service region in northwest Georgia. Please take the time to fill out this survey so that we can offer you low to no cost continuing education opportunities that meet your needs. 

For any questions about this survey or the continuing education program in general, please contact Kristie Washington, the Blue Ridge AHEC RN Re-entry/Continuing Education Coordinator, at kwashington@blueridgeahec.org or 770-680-0823.
 
Required 1.
Please enter the information indicated below.

First Name:
Last Name:
Job Title:
Company Name:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

Required 2.
Please select all professions that apply:
Physician
Physician assistant
Nurse
Nurse Practitioner
Paramedic
Emergency medical technician
Respiratory Therapists
Physical therapist
Occupational therapist
Speech language pathologist
Nutritionist
Mental health counselor/therapist
Social worker
Other  
Required 3.
Please list your degree(s) and/or certification(s):
 

350 characters left.
4.
Please select all specialties that apply:
Anesthesiology
Cardiology/Vascular Medicine
Critical Care/Trauma
Dermatology
Emergency Medicine
Endocrinology
Family Medicine
Gastroenterology
Geriatrics
Healthcare Education and Leadership
Infectious Disease
Internal Medicine
Lifestyle and Mind-Body Medicine
Nephrology
Neurology
Obstetrics and Gynecology
Oncology and Hematology
Ophthalmology
Orthopedics
Otolaryngology
Other  
5.
(Continued) Please select all specialties that apply:
Pain Medicine
Palliative Medicine
Pathology
Pediatrics and Adolescent Medicine
Physical Medicine & Rehabilitation
Psychiatry
Psychology and Mental Health
Pulmonary Medicine
Radiology and Nuclear Medicine
Rheumatology
Surgery
Other