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HEAL: Register
 

Please submit the information below. Your information will be kept confidential and will be used for evaluation purposes only.
  • Note: All items marked with a red star required are required.
USER INFORMATION
required First Name:
required Last (Family) Name:
required Professional Role:
spacer (Check all that apply) 		Faculty Member/Instructor/Lecturer
Course Director
Residency Program Director
Instructional Developer
Dean or Other Administrator
Student or Resident
Librarian
Other: please specify

required Area of Expertise:
Optional  Instructional Level:
spacer (If applicable; check all that apply)		 Consumer Health/Patient Education
Health Profession Education
Higher Education
K-12 Education
required Do you want to be on our mailing list?: Yes No
 
INSTITUTION/ORGANIZATION INFORMATION
required Institution/Organization :
required Country:
required State/Province:
required City:
 
Optional  IAMSE Member?
USERNAME/PASSWORD
Enter e-mail address and select password.
required E-mail Address:
required Confirm E-mail Address:
required Select a Password: 
required Re-Enter Password:
   
 
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Contact the HEAL team at: info@healcentral.org