QI Project Enrollment Form

Complete the information below to request enrollment in a currently approved project. Completion of this form does not verify acceptance. You will be contacted by the project leader or the MOC Portfolio Administrator with additional information. Incomplete or insufficient information may delay approval for participation in the project. Please allow up to 1 week to receive a response regarding your form submission. 
Currently Approved Individual Projects

 Project   Enrollment Cut-Off Date  
 Bronchiolitis (for the outpatient setting)    Open
 Pneumonia (for the outpatient setting)    Open
 Coding and Documentation at ETCH (for the inpatient setting)   Open

Click here for relevant MOC opportunities originating from other portfolio sponsors.

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* 1. Which project would you like to join?

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* 2. A $50 individual project processing fee is required for each project participation.
Click here to submit your processing fee, excluding the Coding and Documentation Project.

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* 3. Please provide the following demographic information. 

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* 4. Would you like to be added to the CME mailing list?

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* 5. MOC project participation at ETCH requires completion of the Institute for Healthcare Improvement (IHI) Open School Online Course: QI 102: How to Improve with the Model for Improvement.
Click here for instructions on accessing this FREE online course.

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* 6. Upload your IHI QI 102 certificate of completion.

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Contact the MOC Portfolio Administrator with any questions: Taylor Oglesby, 865-541-8571, tloglesby@etch.com

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