Member Request Form
Strengthening Forensic Nursing: A Re LAB Project

Thank you for your interest in Strengthening Forensic Nursing: A Re LAB Project.

Please complete the survey below.

Contact Information

First Name

Last Name

Preferred Name

Phone

Secondary email

Demographic Information

Ethnicity

Mark only one oval.

Hispanic or Latino/a

Not Hispanic or Latino/a

Prefer not to say

Gender

Mark only one oval.

Female

Male

Nonbinary/Two-Spirited

Prefer not to say

What is the zip code where you live?

What is the zip code where you work?

SANE Development

Are you a licensed RN or NP?

Yes

Current School/Education Program, if applicable

Current Employer(s), if applicable

Are you employed as a SANE or by a SANE program?

Yes

Have you completed a 40-hour SANE didactic course?

Yes

Are you pursuing certification or recertification as a SANE-A or SANE-P?

Yes

What makes you interested in SANE practice? Please respond in a few sentences.

What areas of SANE practice are you most hoping for support with? Please respond in a few sentences.

What areas of SANE practice do you find most challenging or have concerns about? Please respond in a few sentences.

How did you hear about the UMN SANE: A Trauma Informed Community of Practice program?

SANE Colleague

Employer

Other

Send me a copy of my responses

Member Request FormStrengthening Forensic Nursing: A Re LAB Project