Audio Conference Request Form
“Our mission is to expand the traditional methods of receiving health related services and information in health professional shortage and areas geographically isolated across Northern Michigan”

Please fill out form with as much information as possible.
Once received REMEC will contact you to confirm your request.
Title of meeting:
Date of meeting:
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Time of meeting
Number of callers:
Person Requesting Meeting:
 email:
phone:
Person Facilitating Meeting:
 email:
phone:
Meeting location if applicable:
Other information