Education Request - Maryland TraumaNET

Promoting Excellence in Maryland's Trauma Care

A collaborative statewide approach to address issues related to all aspects of trauma care delivery

Trauma Center Education Request

Please complete this form to request a Trauma Center to come to your institution for education to your staff and providers. A TraumaNet Representative will respond within 3-5 business days to coordinate.

Today's Date *

Name *

First

Last

Email *

Phone Number *

Location (ex. Johns Hopkins Hospital) *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Topic Requested *

Additional Details *

Priority *

1 is low, 5 is critical