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Continuing Education Application Form for Healthcare Professionals, Caregivers, and Faculty Members

Introduction

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Thank you for your interest in participating in the Continuing Education opportunities offered through the Geriatric Workforce Enhancement Program (GWEP) in the Borderland at The University of Texas at El Paso. Supported by the Health Resources & Services Administration (HRSA), this program aims to strengthen the healthcare workforce in our region by delivering high-quality, bilingual training in age-friendly and dementia-friendly care.

These Continuing Educational sessions are designed for professionals, caregivers, and faculty members who currently serve older adults in primary care, long-term care, and community-based settings in West Texas and Southern New Mexico. By completing this form, you are joining a growing network of healthcare providers committed to improving care for older adults.
HRSA requires that the UTEP GWEP project report aggregate results on program participants. Your participation helps us improve our training programs and ensures we meet federal reporting requirements.

What you need to know:
  • It is your choice to complete the application. You can skip questions or stop at any time without any penalty or consequence.
  • Your answers will be kept private. We will not share your name.
  • Any data shared externally will be reported in aggregate form without identifying individual participants
  • All application information will be stored safely.

Questions?
If you have any questions about this evaluation or how your data will be used, please contact Maria Llamas-Martinez, GWEP Manager, at 915-747-7213 or gwep@utep.edu.
By providing your consent below, you acknowledge that the information you provide, including demographic details and professional background, may be used for evaluation and reporting purposes. *This question is required.
Signature:
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Name:
Please provide your name and birth year:
First Name:
Last Name:
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U1Q53051.