R7DHRE Training Request

R7DHRE Training Request

Thank you for your interest in collaborating with the Region VII Disaster Health Response Ecocystem on training opportunities. Please fill out the form below and someone will be in contact with you within 5 business days. If you have any questions, you can reach out to us at R7DHRE@unmc.edu.

Date*

Name*

Organization*

E-Mail Address*

Phone Number*

Best way to contact you*

E-Mail

Phone

What state are you located in?*

Iowa

Kansas

Missouri

Nebraska

What city are you located in?*

Please identify the course you are interested in:*

Advanced Hazmat Life Support (AHLS)

Disaster Management & Emergency Preparedness (DMEP)

Community Readiness Course (CRC)

FCCS - Crisis Management Course

Basic Disaster Life Support (BDLS)

Other

Can your facility accommodate at least 40 pepole?*

Yes

No

What month are you looking to host a course?*

January

February

March

April

May

June

July

August

September

October

November

December

Other Information:

Send me a copy of my responses

Powered by

Privacy Notice|Report Abuse