TTS Core Registration
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By completing this form, you agree to actively partner with the University of Kansas Medical Center (KUMC) School of Medicine, Department of Preventive Medicine and Public Health in trainings, emails, monthly conference calls, and any additional requests for longitudinal tracking purposes of this program. This includes successfully completing the Basic Skills online training by June 30, 2017. Upon successful attendance of the entire 3.5 day in-person Tobacco Treatment Specialist Core Training (August 8-11, 2017), you agree to complete the 2.5 hour online examination. KUMC will cover the cost of hotel (up to $476) and travel (at $0.54 per mile) if residence is greater than 60 miles from Hilton Garden Inn Manhattan in Manhattan, Kansas. Training registration as well as any additional questions/comments can be directed to:

Project Manager, Amanda Grodie, MPH, CHES

Department of Preventive Medicine and Public Health

3901 Rainbow Blvd.

Mailstop 1008

Kansas City, Kansas 66160

AGrodie@kumc.edu

913-588-2761

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