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 Large-Group Projects

 Project   Enrollment Cut-Off Date  
 Antiobiotic Stewardship    Closed
 Appendicitis Care Map  Closed
 Asthma Care Map  Closed
 Bronchiolitis Care Map  Closed
 Cellulitis/Abscess Care Map   Closed
 Croup Care Map  Closed
 Pneumonia Care Map   Closed

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. Please provide the following demographic information. Physician's date of birth (month and day) as well as first and last name must match ABP records exactly to receive points. Every ABP Board certified physician has a unique, ABP ID number. Physicians who do not know their ABP ID can look it up on the ABP website: https://www.abp.org/content/verification-certification.

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

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* 4. 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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* 5. Upload your IHI QI 102 certificate of completion.

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Contact the MOC Portfolio Administrator with any questions: Anna McKay, 865-541-8149, amckay@etch.com

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