Thank you for taking the time to fill out this form. Your answers will help us provide a better experience. First Name * Last Name * Email Address * Will you be attending in person, or virtually? * In Person Virtually/Online Breakout session preference: * Assessment & Management of Gender Dysphoria - James Lehman, MD, MPH Assessment & Management of SUD in Older Adults - Laurel Bessey, MD Incorporating DEI (JEDI) Principles into Clinical Practice - Erri Hewitt, PhD Do you give permission to share your name and email address with the exhibitors at this event? * No Yes Special Dietary Information For meal planning purposes, please let us know if you have any special dietary needs. Vegetarian Gluten Free Other dietary need For meal planning purposes, please let us know if you have any special dietary needs. Other dietary need Leave this field blank
