Describe any quality improvement projects or clinical practice change projects you have accomplished in your practice. Include your role in the project, whether the improvement/change has been sustained, and how you worked with other members of your practice to make the change. What do you want to accomplish as a result of participating in this training? Please briefly describe your goals. Please describe your typical patient demographic specific to insurance coverage. If you do not have patients covered by a particular coverage option, indicate zero (0) percent in the appropriate space. __ Medicaid __ State CHIP program __ Private insurance __ Uninsured __ Other (please specify___________________________________) 100% = Total How did you hear about this training?
Describe any quality improvement projects or clinical practice change projects you have accomplished in your practice. Include your role in the project, whether the improvement/change has been sustained, and how you worked with other members of your practice to make the change. What do you want to accomplish as a result of participating in this training? Please briefly describe your goals. Please describe your typical patient demographic specific to insurance coverage. If you do not have patients covered by a particular coverage option, indicate zero (0) percent in the appropriate space. __ Medicaid __ State CHIP program __ Private insurance __ Uninsured __ Other (please specify___________________________________) 100% = Total How did you hear about this training?