Find Telehealth Providers Tool

Mapping Telehealth Programs in the Northeast

Many thanks for your interest in listing your telehealth program in "Find Telehealth Providers" for the northeast region!

If your organization or practice is located within CT, MA, ME, NH, NJ, NY, RI, or VT and you'd like us to add you to the "Find Telehealth Providers" database and map, please provide the information requested below. Please note that some fields are required, so that we can accurately map your location.

If you have questions regarding the "Find Telehealth Providers" tool or NETRC, please don't hesitate to contact us at:

netrc@mcdph.org or 1-800-379-2021.

Site Demographics:

Question Title

* Organization or Practice Name

Question Title

* Primary Contact Information (will be used to request annual updates, but will not be publicly available)

Name (First, Last, Credentials)

Email:

Phone:

Question Title

* Provider/Organization Website:

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* Physical address of site(s) providing telehealth services

Site 1 (a pin will be placed on the map at this location):

Address:

City/Town:

State:

ZIP:

Question Title

* Site 2 (a pin will be placed on the map at this location)

Address:

City/Town:

State:

ZIP:

Question Title

* Site 3 (a pin will be placed on the map at this location)

Address:

City/Town:

State:

ZIP:

Question Title

* Site 4 (a pin will be placed on the map at this location)

Address:

City/Town:

State:

ZIP:

Please email netrc@mcdph.org if you would like to map more than 4 sites

Question Title

* Site Type (if applicable)

Hub

Spoke

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* If you are a spoke site, please list all hub sites that you currently work with:

Hub 1:

Hub 2:

Hub 3:

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* Provider Setting Type (choose all that apply):

Academic Medical Center

Area Agency for the Aging

Community Services Board/Mental Health Center

Correctional Facility

Critical Access Hospital

Employee/Occupational Health

Federally Qualified Health Center/Community Health Center

Free Clinic

Health Department

Home Health

Hospital/Health System

Nursing Home/Skilled Nursing Facility

Other Inpatient Facility

Outpatient Clinic/ Urgent Care Facility

PACE

Private Practice (either solo or group)

Rural Health Clinic

School Health

Other (please specify)

Types of Telehealth you Currently Provide (select all that apply):

Question Title

* General Telehealth Utilizations:

Chronic Disease Management/ Remote or Home Monitoring

Specialty Services

Continuing/Provider Education

Health/Patient Education

Personnel Education

Medical Interpretation

Other (please specify)

Telehealth Specialty Areas/Programs you Provide (select all that apply):

Question Title

* Telemedicine

Cardiology

Dentistry

Dermatology

edCU

ENT

Emergency Medicine

Genetics

Geriatrics

Infectious Disease

Nephrology

Neurology/Stroke

Oncology

Opthalmology

Orthopedics

Pathology

Pharmacy

Primary Care/Family Medicine

Psychiatry/ Mental Health

Radiology

Surgery

Trauma

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* Population Based Screening

Colposcopy

Diabetic Retinopathy

Mammography

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* Telerehabilitation

Assistive Technology

Occupational Therapy

Speech Therapy

Telepsychiatry

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* Women's Health

Family Planning

Gynecology

Obstetrics

Perinatology

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* Other Telehealth Services (please list any not available above, separated by a comma)

Question Title

* Do you have any plans to expand your telehealth services?

Yes

Question Title

* If yes, please elaborate on your plans for expansion:

Many thanks for your time and assistance in advancing telehealth in the northeast!
Please visit our website to view the "Find Telehealth Providers" map, or to learn more about NETRC.

Question Title

* Organization or Practice Name

Question Title

* Primary Contact Information (will be used to request annual updates, but will not be publicly available)

Question Title

* Provider/Organization Website:

Question Title

* Physical address of site(s) providing telehealth servicesSite 1 (a pin will be placed on the map at this location):

Question Title

* Site 2 (a pin will be placed on the map at this location)

Question Title

* Site 3 (a pin will be placed on the map at this location)

Question Title

* Site 4 (a pin will be placed on the map at this location)

Question Title

* Site Type (if applicable)

Question Title

* If you are a spoke site, please list all hub sites that you currently work with:

Question Title

* Provider Setting Type (choose all that apply):

Question Title

* General Telehealth Utilizations:

Question Title

* Telemedicine

Question Title

* Population Based Screening

Question Title

* Telerehabilitation

Question Title

* Women's Health

Question Title

* Other Telehealth Services (please list any not available above, separated by a comma)

Question Title

* Do you have any plans to expand your telehealth services?

Question Title

* If yes, please elaborate on your plans for expansion:

* Physical address of site(s) providing telehealth services

Site 1 (a pin will be placed on the map at this location):