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Stroke Support Group

Event Registration Form for: Stroke Support Group

Registration requests are processed Monday-Friday, from 8am-5pm. Registration requests received after 5pm on Friday will not be processed until 8am Monday.

Please fill out the boxes below with your contact information. Please note that fields marked with * are required information.

* First name:

* Last name:

* Address 1:

Address 2:

* City:

* State:

* Zip:

* Daytime phone:

* Evening phone:

E-mail address:

How many guests are you bringing?

* How did you learn about this event?

Additional information:

Can we contact you by e-mail about future events, opportunities, and other program information?

Yes No

If you have questions about physical access, please call (919) 470-6520 in advance of attendance.

2011		2012		2013
Jan	Feb	Mar	Apr	May	Jun
Jul	Aug	Sep	Oct	Nov	Dec

	S	M	T	W	T	F	S
»	25	Motherhood: The New Reality Show Forward Motion Program For Hip / Knee Replacement Baby Care Class Holiday Hurt: Living through the Holidays after a Death 26	Tour The Birth Place At Durham Regional Hospital Prepared Childbirth Class Series 27	Pediatric Pointers from A Pediatrician Back To Work- For New Moms Breastfeeding Class 28	Duke Weight Loss Surgery - Durham Informational Seminar 29	30	1
»	Breastfeeding Class 2	Motherhood: The New Reality Show Managing Sodium and Checking for Weight Gain with Congestive Heart Failure Baby Care Class 3	Weight Loss Surgery Support Group - Durham Confusion in the Elderly: Help for Caregivers Tour The Birth Place At Durham Regional Hospital 4	Infant Massage Class Series Infant/Child CPR And Safety (PBLS) New Tools For New Dads 5	Duke Weight Loss Surgery - Durham Informational Seminar 6	7	8
»	9	Motherhood: The New Reality Show Forward Motion Program For Hip / Knee Replacement Stroke Support Group 10	Tour The Birth Place At Durham Regional Hospital 11	Infant Massage Class Series Breastfeeding Class Choosing Quality Child Care Duke Weight Loss Surgery - Chapel Hill Informational Seminar 12	Duke Weight Loss Surgery - Greensboro Informational Seminar 13	14	Baby Care Class 15
»	16	Motherhood: The New Reality Show Baby Care Class 17	Breastfeeding Class Duke Weight Loss Surgery - Burlington Informational Seminar Back To Work- For New Moms Tour The Birth Place At Durham Regional Hospital 18	19	Duke Weight Loss Surgery - Durham Informational Seminar 20	21	22
»	23	24	25	26	27	Forward Motion Program For Hip / Knee Replacement 28	29
»	30	31	1	Baby Care Class 2	New Year Nutrition: How To Make This A Healthier Year Duke Weight Loss Surgery - Durham Informational Seminar Breastfeeding Class 3	Forward Motion Program For Hip / Knee Replacement 4	Infant/Child CPR And Safety (PBLS) 5

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Stroke Support Group

Event Registration Form for: Stroke Support Group

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