Trainee/Learner/Attendees Request a Class - Community Health Center Network

At CHCN, we are interested in hearing from attendees about ideas for future trainings. Please share your suggestions with us by completing the information below.

1. Describe the topic or subject you want the course to address.
What new knowledge or information do you want to gain from this course?
2. If you are requesting a course for a specific learner group (e.g., providers, clinic staff, nurses, front office, etc.) please describe that group.
3. In order to develop a course that meets your needs, we need to work with either subject matter experts or have training materials that help develop an appropriate curriculum.
Can our Director of Training contact you to discuss the Learning Objectives for the course and content? If yes, please provide your contact information or that of someone who could help us better understand your request and meet your training needs.
Please provide your contact information so the CHCN Director of Training can contact you to discuss the request.
Name*
First Last
Email*
Organization
Would you recommend that this course be
- In-person (e.g. at CHCN)
- Online (e.g. a webinar)
- Self-paced online (e.g. Powerpoint or other prepared materials)
CHCN eNewsletter*
Add email to receive CHCN eNewsletter
- Yes
- No
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