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On-site Leadership Training Interest Form
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First Name *
Last Name *
Email *
Primary Work Organization *
How many people do you expect to attend, and what disciplines do they represent? *
What is your institution’s experience with Balint groups to date? Are there any Balint groups running currently? *
What are your objectives for the on-site training? What change do you hope for at your institution as a result of the training? *
What is your time frame for hosting an on-site training? *
Do you already have funds which can be used towards hosting an on-site training?
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