Alive! Maryland Eligibility and Enrollment Workforce Form

Thank you for your interest in the Alive! Maryland project.

The Maryland Department of Health has engaged with HealthHIV, a national capacity building organization, to launch Alive! Maryland, a comprehensive capacity building initiative for the infectious disease and primary care workforce in the State of Maryland.

The information gathered is intended to provide insight into the competency-based training and technical assistance needs of the State of Maryland's Infectious Disease and Primary Care Workforce. It will be used to inform the design, development, and delivery of competency-based curricula to strengthen the technical capacity of Maryland's infectious disease and primary care workforce and will support the work of the Ending the HIV Epidemic initiative.

You will be completely anonymous as a participant. The information collected here will be kept confidential and reported only in aggregate. We will not share your personal information with any outside parties.

For more information about this project, contact Anna Bacharach at If you have questions regarding your rights as a participant, you may contact Gay Hutchen at the Institutional Review Board of the Maryland Department of Health at 410-767-8448 and email

Loading... Loading...
You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.