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EVENT REGISTRATION

To register for a class or event, please fill out the form below.

Payment must be received at the time of registration. After completing this form, you will be contacted by HealthConnect in the near future to complete the registration process and collect payment.

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Event Information:

Breastfeeding Basics
03/20/14, 6:00 PM - 8:30 PM
05/15/14, 6:00 PM - 8:30 PM
07/17/14, 6:00 PM - 8:30 PM
09/18/14, 6:00 PM - 8:30 PM
11/20/14, 6:00 PM - 8:30 PM
Your Information:

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MI:
* Last Name:
Date of Birth:
I am a SwedishAmerican Health System employee
* Address:
* City:
* State:
* Zip:
* Daytime Phone:
  
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E-mail:
Contact Us
SwedishAmerican
1401 East State Street
Rockford, IL 61104
(815) 968-4400
patientfeedback@swedishamerican.org

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