Summary of Care - Workgroup opportunity for
healthcare providers to plan for achieving Stage
2 Summary of Care Measure.

Question Title

1. Please Provide Your name and Organization Information

Name

Organization

Organization Address

Contact email

Phone

Fax

Direct email Address (If applicable)

Question Title

2. Are you planning to attest to Meaningful Use Stage 2 in 2014? (Required.)

Yes

No

Question Title

3. Are you planning to attest to Meaningful Use Stage 2 in 2015? (Required.)

Yes

No

Question Title

4. Would you like to participate in the upcoming Summary of Care Workgroup calls to learn more?

Yes

No