Partnership Inquiry Form
I appreciate your interest in working with the Piedmont Area Health Education Center. Please provide general information about the continuing professional development activity for which you wish to partner with the Piedmont AHEC.

When you complete it, please click on the button at the bottom of the form. Our Educational Activity Review Team will consider your request within seven days of receiving it. A representative will contact you to discuss the next steps.
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    Please include month, day and year.
  • Include street address, city, state and zip code.
  • Note: The practice gap is the difference between what actually occurs and what the ideal or evidence-based practice should be, or, the problem the activity is trying to solve.
  • Please provide specific description and/or attach documentation (up to 3 files below)