Please use this form to express your interest in learning more about the FMEC's newest project which will help veterans better access interdisciplinary care including oral health care. Veterans are an underserved population, and they are in need of innovative solutions that link behavioral health, oral health, and other services. Help us create new models by being a project leader and/or participant!

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* 1. Name

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* 3. Residency Program/Clinic Name

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* 4. Title/Role

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* 5. Please use the space below to make any suggestions or ask any questions for the project. (OPTIONAL)

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* 6. I'm interested in the project! I am interested in: (check all that apply)

Thank you for completing this! Please share with others you think would be interested in joining the project. The Family Medicine Education Consortium will be in touch soon, or contact Scott Allen, scott.allen@fmec.net.

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