Polysubstance During Buprenorphine Treatment
This is the registration for the July 26, 2022 webinar,  "Polysubstance During Buprenorphine Treatment".

Please join the Michigan Opioid Collaborative for an informal, interactive dialogue on
polysubstance during buprenorphine treatment. Bring your questions, thoughts, and
perspectives.

Kindly note, within a few days of your registration submission you will receive a Zoom link. If you have any questions please email Ashley Bushner (asbushne@med.umich.edu).
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1. First Name *
2. Last Name *
3. Provider Role (physician, social work, etc.) *
4. Which organization are you with? *
5. What is the location of your organization? *
6. Which county is your organization located in? *
7. How did you hear about this webinar?
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8. If you answered "Provider Organization" above, please specify which.
9. If you answered "Community Newsletter" above, please specify which.
10. Questions you would like to ask ahead of time
11. Cases you would like discussed
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