Baystate Health & Health New England Annual Community Benefits Forums Registration
Name
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First Name
Last Name
Company/Organization
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Job Title
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Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Format: (000) 000-0000.
Email
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example@example.com
Dietary Requirements?
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We will do our best to accommodate any reasonable requests. If none, please type "none".
Do you require accommodations to fully participate?
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Please Select
Yes I do
No, I don't
Please describe them briefly below
I plan to attend the following CB Forum(s):
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Baystate Medical Center - Monday, November 3, 2025, From 11:00 am - 12:30 pm @ Educare Springfield Room A
Baystate Wing Hospital - Wednesday, November 5, 2025, From 10:30 am – 12:00 pm @ Palmer Public Library Community Room
Baystate Noble Hospital - Tuesday, November 12, 2025, From 2:00 pm – 3:30 pm @ Westfield State University Owl's Nest in Ely Campus Center
Baystate Franklin Medical Center - Thursday, November 13, 2025, From 9:00 am – 11:00 am @ BFMC Conference Room A & B
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