Palliative Care Rotation: Registration Form

Use this form after you have successfully obtained a University of Minnesota Internet ID (x.500). This information will be used to enroll you in the online Palliative Care Rotation curriculum.

Please provide your preferred e-mail address.
Which profession are you studying at your university/college?
Your x.500 is your unique Internet ID for the University of Minnesota. If you have not already signed up for an Internet ID, please do so now by following these steps.
Provide the name of your preceptor at your clinical rotation site.

University of Minnesota HRSA Northeast AHEC mnHEALTHnet

The website is funded by the Northeast Minnesota Area Health Education Center's mnHEALTHnet (Northeast Minnesota Interprofessional Rural Health Network) Palliative Care Initiative (PallCI). PallCI is a Rural Health Workforce Development Program funded through Health Resources and Services Administration (HRSA), Office of Rural Health Policy #6G98RH19709-01-01.