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
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Date of meeting
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May 2012
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Time of meeting
Number of callers
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Person Requesting Meeting
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email
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phone:
Person Facilitating Meeting:
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phone:
Meeting location if applicable:
Other information