Register for the CHW Directory

First Name

Last Name

Email

County in NJ

State/Province of Work

Organization Name

Job Title

Are you employed as a CHW?

Do you work directly with patients/clients?

Do you supervise staff members who work directly with patients/clients?

Please indicate your industry/sector:

What professional discipline BEST describes you?

Have you completed CHW education and certification training?

Describe the program you worked in and/or population served?

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