ACT Course Application Form - 2027

Registration Closes: November 15, 2026

The ‘Achieving Competency Today (ACT): Issues in Health Care Quality, Costs, Systems and Safety’ course is a graduate-level interdisciplinary curriculum for systems-based practice and practice-based learning and improvement. Interprofessional teams work collaboratively to design and test solutions to identified challenges in healthcare delivery through an improvement project.

Contact information

Question Title

1. Name:

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2. Phone:

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3. Email

Experience and qualifications

Question Title

4. Which of the following best describes your job category?

M.D./D.O.

PharmD

Advance Practice Clinician (APN/PA-C)

Medical Student

Allied Health Professional

Other

Other (please specify)

ACT Course Application Form - 2027

Registration Closes: November 15, 2026

Question Title

1. Name:

Question Title

2. Phone:

Question Title

3. Email

Question Title

4. Which of the following best describes your job category?

Question Title

5. Please describe a brief summary of why you would like to take this course.

Question Title

6. Upload Letter of Recommendation from Manager

Question Title

7. Upload Resume / Written Work History

ACT Course Application Form - 2027

Registration Closes: November 15, 2026

Question Title

* 1. Name:

Question Title

* 2. Phone:

Question Title

* 3. Email

Question Title

* 4. Which of the following best describes your job category?

Question Title

* 5. Please describe a brief summary of why you would like to take this course.

Question Title

* 6. Upload Letter of Recommendation from Manager

Question Title

* 7. Upload Resume / Written Work History

1. Name:

2. Phone:

3. Email

4. Which of the following best describes your job category?

5. Please describe a brief summary of why you would like to take this course.

6. Upload Letter of Recommendation from Manager

7. Upload Resume / Written Work History