Thank you for your interest in becoming a mentor in AFHTO's ED Mentorship Program to help new EDs excel! Please complete this survey. This information will help us make appropriate mentor-mentee matches. 

We will be in touch soon.

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* 1. Please provide your name and contact information

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* 2. How long have you been an executive director in a family
health team, NPLC, or other team-based care model?

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* 3. What types of models have you worked in? Please check all that apply.

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* 4. Please check all areas in which you have expertise in a team-based primary care model

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* 5. What appeals to you the most about joining this program?

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