Please complete this form for your practice if interested in participating in Transforming Clinical Practice Initiative (TCPI) efforts. The NRHI SAN team will connect you with the appropriate organizations in your region.

For more information please contact: Stacy Donohue, Senior Program Manager: sdonohue@nrhi.org

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* 1. Today's Date:

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* 2. Full Name:

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* 3. Contact information (email):

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