Albany Medical Center
 Search
Home / About Us / Patient Care / Education / Research / Directories / Maps & Directions / Ways to Give / News & Publications / Find a Doctor / Careers
Maps & Directions
Join our Mailing List
Enter your e-mail address to be notified of upcoming initiatives
 

Patient Care

Downlink Site Registration

Please complete ALL information below and submit electronically or return to:
Jim Ybarra at FAX: (518) 262-8460

I have read and understand the Instructions for Coordinating a Videoconference Downlink Site.
 
Number of sites that will participate:
Please estimate the number of attendees:
Please list the cities in which you have confirmed sites:
 
Your Name:          First:
Last:
Phone Number:   
Institution Name:
Address Line 1:  
Address Line 2:
Physical Address only. Do not use P.O. Box.
City:
State:
Zip Code:
Fax Number:
Email Address: