2025 Annual Conference Healthy Communities: Social Drivers of Health and Health Systems Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name *AffiliationAddressAddress Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Email *Method of Payment *CheckInvoicePayPalN/APlease select which attendance fee applies:In-person (meals/snack included) –$100Virtual (Friday only) – $50Do you need Continuing Education for Nursing or Social Work? (Additional $15 per day)YesNoPlease select your college affiliation:Staff/FacultyStudentN/AFor College Staff/Faculty and students, meals are not included with the donation price. Do you want to purchase a meal/snack?Yes – $35No $20) Affiliation Nursing In Person College Staff/Faculty (Suggested donation of $20) – Students (Suggested donation of $10) — Virtual College Staff/Faculty (Suggested donation of $20) – Students (Suggested donation of $10)Please check off which of the following events you plan to attend:Thursday, Sept. 18, 2025 Events1:00 - 4:00 PM – Workshop: Grassroots Healthcare Advocacy: Why, How, When 4:00 - 5:00 PM – Social Time/snacks5:00 - 8:00 PM – Documentary & Panel – Medicine Man: The Stan Brock Story Includes panel discussion featuring: Wendell Potter - Former Healthcare Executive & Whistleblower Jeff Eastman - CEO of Remote Area Medical (RAM)Workshop (Suggested donation of $20) – Documentary & Panel (Suggested donation of $10)Friday, Sept. 19, 2025 Events09:00 - 10:00 AM – Light Breakfast10:00 - 11:15 AM – Keynote Place-Based Approaches in Addressing Social Determinants of Health11:30 - 12:30 PM – Session 1: Unraveling the Web: Strategies for Navigating Healthcare-related Mis/disinformation in the Social Media Era.11:30 - 12:30 PM – Session 2: Un-Natural Supports: The Familial Responsibility in a Complex Healthcare System12:30 - 1:30 PM – Lunch Break1:30 - 2:30 PM – Session 3: SNAP, Medicaid, and Your Community – Navigating New Realities1:30 - 2:30 PM – Session 4: Innovating Solutions in Tennessee: Industry leaders brainstorm a theoretical grant live with the audience2:45 - 4:15 PM – Closing Plenary: Impact of Congressional Budget on Healthcare in TennesseeIf you have any food allergies or dietary preferences, please make note here.Submit
