The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

gDuoonvqYFMjI4CkbWkXb6SPENH99TvDepKnEM2u8MZiqxrRng8rpTFCF6wZQKspIgrzQrFzqWqAsHYeDKD4zL7bg

HSVH Training Registration Form

Please complete the survey below to register for a course through Tennessee Department of Health's HSVH section. For more information about courses being offered and a course calendar, click here.

If you have questions about your registration, or need confirmation of your course date, please email HSVH.CBA@tn.gov.

Name:

* must provide value

Email address:

* must provide value

Phone number:

* must provide value

Are you an employee of a Tennessee health department or public health office?

* must provide value

Yes

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Health Department/Office:

* must provide value

Organization:

* must provide value

Job Title:

* must provide value

Please indicate which of the following Tennessee Department of Health HSVH projects you support. Choose the one option that most accurately reflects the majority of your work:

* must provide value

Please select a training course to attend. For more information on the courses offered and to see a current course calendar, please check out the HSVH Capacity Building Assistance online hub.

Please indicate the name of the training you are registering for today:

* must provide value

Desired course dates:

All courses close two weeks before their run date. Selecting a course date here is not a guarantee that you have a seat in a course. You will receive confirmation that you either have a seat in an upcoming course or are on a waiting list.

To confirm your course registration, please contact HSVH.CBA@tn.gov.

How did you learn about this training course? (If you heard about this course from more than one source, please choose the source that best reflects how you want to receive information about training in the future.)

* must provide value

Most courses are virtual with digital materials. If you select a course that mails materials to participants, where should we send your course supplies?

(Please provide your mailing address for training materials, including your name, the street address, the city, the state, and the zip code.)

To participate in an HIV, STI, or Viral Hepatitis course through the Tennessee Department of Health for certification, please agree that all of the following are true:

* must provide value

I have access to a webcam and can be on camera for a virtual training.

I have access to speakers, headphones, or other technology to allow me to both speak and listen during virtual training.

I am available for the entire duration of the training course.

I am not scheduled for additional work duties during the duration of the training course.

I have provided my mailing address to the trainer for pre-course materials.

I can and will complete all pre-course assignments. Where applicable, I will submit pre-course certificates to my trainer.

If you were not able to commit to all of the course agreements due to a technical or scheduling issue, please contact HSVH.CBA@tn.gov as soon as possible to complete your registration.

Additional comments, information, or questions:

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All demographic questions are optional, but will help us to better understand who we are serving with our training courses. You may chose to answer some of them, all of them, or none of them.

Please tell us more about yourself:

How old are you?

Under 18 years

18 to 25

26-35

36-45

46 years or older

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What is your gender type?

Transgender

Cisgender

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What is your gender?

I am a woman.

I am a man.

I am non-binary.

None of these describe my gender.

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What best describes your race and/or ethnicity? (Choose all that apply.)

Hispanic or Latinx

African American

American Indian or Alaskan Native

Asian

Native Hawaiian or Pacific Islander

White

Other

What is your sexual orientation?

Heterosexual

Gay

Lesbian

Bisexual

Pansexual

Queer

None of these describe my sexual orientation.

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What best describes the role you play in the HIV Public Health Workforce? (Choose all that apply.)

Clinician

Social Worker

Case Manager

Linkage to Care

Disease Intervention Specialist

HIV Tester

PrEP Navigator

Community Health Educator

Other

Thank you for registering for training through Tennessee Department of Health.

For more information about the status of your training registration please email HSVH.CBA@tn.gov.

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.