Advance Directives: Your Life, Your Choices Workshop Registration

Thank you for your interest in the Your Life, Your Choices workshops. We limit the number of participants per workshop, so we fill sessions on a first-come, first-served basis.

After registering, you will receive a confirmation letter, phone call, or e-mail a few weeks prior to the workshop. If the session is filled, you will be contacted about alternative dates or locations.

These workshops are open to the public. There is no charge for you and a guest. For more information about these classes, contact the program coordinator at 1-866-458-5276.

Check the schedule and note when and where you would like to attend this workshop.

*Indicates a required field

MM/DD/YYYY

Will you be attending with a spouse, family member, or friend?

How did you hear about Advance Directives: Your Life, Your Choices? (Please check all that apply.)

This form will be sent via e-mail, an unsecured means of communication. While Group Health takes careful measures to protect the privacy and confidentiality of any information you send us, we cannot absolutely guarantee secure transmission of your information from your computer to our servers. To register by phone, call the Your Life, Your Choices program coordinator at 1-866-458-5276.

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