CKM Certification Participation & Interest

CKM Health Certification Interest Form

The Cardiovascular-Kidney-Metabolic (CKM) Health Initiative seeks to integrate CKM health metrics into existing data registries, develop a scalable, patient-centered certification framework and establish a CKM health recognition program for providers and health systems. If you are interested in participating in or applying for CKM health certification, please share your information below.
Primary Contact Name*
Primary Contact Job Title*
Primary Contact Email*
What type of health care organization do you belong to?*
Organization Name*
What is your site's ZIP code?*
Which electronic health record (EHR) provider does your organization use?*
Which elements of CKM Certification are you interested in? Check all that apply.

Participating in certification standards testingParticipating in the open comment phase of certification standards testingProfessional certification (for CKM Coordinators)Other
The American Heart Association's Cardiovascular-Kidney-Metabolic Health Initiative is made possible by Founding Sponsors Novo Nordisk and Boehringer Ingelheim, Supporting Sponsor Novartis Pharmaceuticals Corporation, and Champion Sponsor DaVita.
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CKM Health Certification Interest Form