Thank you for your interest in presenting a breakout session for the 2015 NETRC annual conference!

Our theme this year is: "Integrating Telehealth in an Evolving Landscape". We are looking for breakout sessions which provide practical information and resources for telehealth implementation in both current and future healthcare environments - for example, the role of telehealth in the transition from fee-for-service to quality based payment models.

Proposal Due Date: Thursday, April 16th, 2015
Please complete the following application by the due date in order to be considered.

Proposals will be reviewed during the week of April 20th, and all applicants will be notified of their selection status by Monday, April 27th.

Many thanks for your time and interest in sharing your telehealth program and/or expertise with stakeholders throughout the region!

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* 1. Presenter Contact Information:

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* 2. Brief Bio - Primary Presenter: (250 words or less please)

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* 3. Additional Presenter Contact Information:

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* 4. Brief Bio - Additional Presenter: (250 words or less please)

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* 5. Title of Your Presentation:

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* 6. Which particular area(s) of telehealth do you feel your session is most relevant to: (please select all that apply)

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* 7. Breakout Session Summary:

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* 8. Learning Objectives for Your Session: (Please list three)

Thank you for your submission - we'll be in touch soon!

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