Building Community Trust to Increase Covid-19 Vaccination
Complete this form to register for the free webinar on Wednesday, May 26, 2021, from 12-1, sponsored by Hawaii Pacific Health and the Hawaii Immunization Coalition. Each participant needs to register separately. This form is required for those who want to receive continuing education credits through Hawaii Pacific Health (pharmacists, nurses, physicians, social workers)
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Email *
What is your first name? *
What is your last name? *
What is your phone number? *
On what island do you reside? *
Where do you work or with what organization are you affiliated? *
What is your role? *
How did you hear about this webinar? *
Required
Please rate your ability to meet the following program objectives. *
1 - Not at all
2 - A little
3 - Somewhat
4 - Mostly
5 - Expert
Identify barriers to building community trust in COVID 19 vaccination
Incorporate evidenced-based research and talking points with patients, to increase community trust in obtaining COVID vaccinations.
Describe ways to reach out to Hawaii's at-risk populations to promote vaccination.
Any other comments or questions?
A copy of your responses will be emailed to the address you provided.
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