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Injury Prevention Course Report
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Injury Prevention Course Report
* Indicates a Required Field
Date of Injury Prevention Activity:*
Region:*
-- Select One --
Adirondack
Brooklyn/Staten Island
Central
CHATT
Genesee
Lower Hudson
Manhattan Bronx
Mark Twain
Mohawk Valley
Nassau/Queens
Southern Tier
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Type of Injury Prevention Activity:*
-- Select One --
Alcohol and Substance Abuse Prevention
Fall Prevention
Driver Safety
Pedestrian Safety
Child Passenger Safety
Firearm Safety
Helmet Safety
Head Injury Safety
Suicide Prevention
Outreach/Street Fair
Other
Other Activity:
Name of Injury Prevention Activity:*
Location:
Presenters:
Number of Participants:*
