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  • Alaska Pain & Opioid Management (POM) ECHO

    PRE-SESSION SUBMISSION FORM
    • Questions about a case submission? (click dropdown for more information) 

    • Case Submission Instructions:

      Case presentations are an integral tool which Project ECHO uses to affirm our all teach/all learn philosophy. The aim for case presentations is to invite our participants to share their expertise, lived and learned, and to create a forum where complex issues can be examined with nuance and care.

      If you could use some feedback on a patient, situation, or challenge that you are facing, this ECHO is the place to do that and we would love to get you added to the schedule!

      • Cases should be relevant to the ECHO Series, but are not required to be specific to the session topic.
      • Cases can be past or present examples describing an individual, situation, or challenge in your practice.
      • All cases should be de-identified prior to submission.
      • The group will work together to offer recommendations in real-time.

      Still have questions? Reach out to us via email: echo@alaskachd.org

  • CASE SUBMISSION FORM

    Alaska Pain & Opioid Management (POM) ECHO

  • This form contains fields that are not required. Please use them as prompts to provide enough information relevant to understanding the case.

    Reminder: No protected health information is to be shared in ECHO

  •  / / Pick a Date

  • CASE BACKGROUND

    Reminder: No protected health information is to be shared in ECHO

  • PATIENT / CLIENT SUMMARY

    Reminder: No protected health information is to be shared in ECHO. The following questions are optional, not every field needs to be completed.

  • CASE BACKGROUND

    Reminder: No protected health information is to be shared in ECHO

  • QUESTIONS / COMMENTS

    Alaska Pain & Opioid Management (POM) ECHO

  • Contact Information (Optional)

  • SUBMIT A TOPIC IDEA TO OUR PAIN & OPIOID MANAGEMENT (POM) ECHO TEAM

    We would like to hear from you on topics which would be beneficial for you, your staff, and your patients. Topics can be focused on the management of specific diseases or conditions which you are encountering in your practice, best practices for working with specific populations, or systems level interventions. We welcome your thoughts and suggestions!

  • Please submit at least three things you'd like us to address in future Pain & Opioid Management (POM) ECHOs:

    You can submit another form if you have more than 3 ideas.
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