Please complete the form below to express your interest in being a member of the AKI Workgroup and/or to share your program's current AKI protocol.  Members of the Workgroup will collaboratively work to develop a robust protocol while utilizing VCSQI data to measure progress. 


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* 1. Contact Information

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* 2. Check all that apply

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* 3. Does your organization currently have an AKI protocols in place?

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* 4. Please provide the email addresses of additional individuals you would like to invite to participate in this workgroup. 

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* 5. Please attached a copy of your AKI protocol.

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