Skip to content
Care Coordination ECHO Registration
This ECHO will focus on strategies to improve care coordination for families with young adults, with special healthcare needs, transitioning from pediatric to adult care.
May 2023 - November 2023
*
1.
Your Information
(Required.)
First Name
Last Name
Position Title
Email Address
Work Phone Number
*
2.
Job Category
Select the category based on how you will be participating in the ECHO.
(Required.)
MD, DO
NP
PA
Community Health Worker
Pharmacist
Patient Health Navigator
RN
School Nurse
LPN
CNA
Medical Assistant
Nurse Care Manager
Care Coordinator
Peer Support Specialist
Peer Recovery Specialist
OT
PT
SLP
Behavioral Health Provider
Social Work (LICSW, MSW)
Family Visitor
Administration
Other (please specify)
*
3.
Organzation Information
(Required.)
Org Name
*
Address
*
Address 2
City/Town
*
State/Province
*
ZIP/Postal Code
*
*
4.
Area of Specialty
(Required.)
Adult Medicine
Family Medicine
Internal Medicine
Pediatric Medicine
Primary Care
Community Advocate
Behavorial Health
Education/School
Administration/Policy
Other (please specify)
*
5.
Type of Work Setting
(Required.)
Primary Care Setting
Community Setting
Hospital Setting
School Setting
State Agency
Administration
Other (please specify)
