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HSAG-AAFP METRIC Hypertension Study - Training Session I: Overview and Timeline

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* 1. Please enter the following information for your physician practice. (All fields are required.):

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* 2. Please enter the following information for the primary person in your practice who will be responsible for preparing and sending the Master List of potentially eligible patients to HSAG. (All fields are required.):

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* 3. What is the date that the above-named person (from question 2) viewed this training session (mm/dd/yyyy)?

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* 4. Please enter the following information for the person HSAG should contact if we have questions related to your Master List of eligible patients?

(If this is the same person, enter "same" in the Name and Credentials box and go to the next question. If this not the same person, please fill out all fields.)

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* 5. Please enter the following information of the primary person in your practice who will be responsible for completing the medical record chart reviews?

(If this person is listed above, enter "same as #2" or "same as #4" in the Name and Credentials box and go to the next question. If this not the same person, please fill out all fields.)

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* 6. What is the date that the above-named person (from question 5) viewed this training session (mm/dd/yyyy)?

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