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SMBP Program Technical Assistance Request - 2022-2023

As part of Comagine Health’s Partnership with the New Mexico Department of Health’s Heart Disease and Stroke Prevention Program (HDSPP), you have the opportunity to receive FREE technical assistance to support your Self-Measure Blood Pressure Program (SMBP)
 
Please complete the following questionnaire to indicate your interest in receiving NO COST Targeted Technical Assistance.
1.Organization Name(Required.)
2.City(Required.)
3.Primary Staff Contact Name:
4.Primary Staff Contact Title:(Required.)
5.Primary Staff Contact Email:(Required.)
6.Primary Staff Contact Phone:(Required.)
7.Please list the counties served by your organization:
8.Where are you in your self-Measured Blood Pressure Journey?(Required.)
9.Are you interested in receiving targeted technical assistance in any of the following areas? Mark all that apply
10.Is there anything else you would like us to know about your TA needs around SMBP?