Sign Up – Ohio Association of Genetic Counselors

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First Name

Last Name

E-mail Address

Alternative Email

Password

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Are you a board certified or board eligible genetic counselor?

You are eligible to be a Full Member. Would you like to register as a Full Member?

What is your primary area of practice?

Other specialty:

Place of Employment

If you live in the state of Ohio, in what region do you live?

Are you currently a student enrolled in a Genetic Counseling training program in the state of Ohio?

What genetic counseling training program are you currently enrolled in?

Optional: Gender Identity

Self-described gender identity:

Optional: Race (please check all that apply)

Other race:

Optional: Are you of Hispanic, Latino/a/x, or of Spanish origin

Other ethnicity:

You are eligible to be a Student Member. Would you like to register as a student member?

You are eligible to be an Associate Member. Would you like to register as an associate member? (Please select "No" if you have already opted to register as a Full Member).

Only fill in if you are not human