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FORMULARIO DE REGISTRO (REGISTRATION FORM)
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Título del Curso: United States Conference on HIV / AIDS
(Course Title: United States Conference on HIV / AIDS USCHA )
Fecha: 7-11 de octubre de 2022 (Date: October 7-11, 2022) Lugar: Centro de Convenciones de Puerto Rico (Place: Puerto Rico Convention Center)
Nombre e Inicial (Name and Initial)
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Apellido Paterno (Paternal Surname)
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Dirección Postal (Postal Address)
PO Box
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Peublo (Town)
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País (Country)
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Código Postal (Postal Code)
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Teléfono Celular (Cell Phone)
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Teléfono del Trabajo (Work Phone)
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Lugar de Trabajo (Work Place)
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Profesión (Profession) :
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18 Consejero(a) Profesional (Counselor)
20 Dentista (Dentist)
26 Educador(a) en Salud (Health Educator)
27 Educador(a) en Salud Comunal (Community Health Educator)
29 Enfermero(a) Especilista (Specialist Nurse)
30 Enfermero(a) Generalista (Generalist Nurse)
34 Enfermero(a) Práctico(a) (Practitioner Nurse)
35 Enfermero(a) Asociado (Associate Nurse)
38 Farmacéutico (Pharmacist)
39 Auxiliar de Farmacia (Pharmacy Assistant)
49 Psicólogo(a) (Psychologist)
Trabajador(a) Social (Social Worker)
Médico (Physician)
Other:
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