Web_TeamCoCM_Registration_7/23

Supporting Your Team in the Collaborative Care Model: Lessons from the Field
Thursday, July 23, 2:00-3:00p.m. ET

This virtual session is supported by the Center of Excellence for Integrated Health Solutions, funded by a grant award from the U.S. Department of Health and Human Services. If you have questions about these sessions, please contact Integration@TheNationalCouncil.org.
Name

First NameLast Name
Email
example@example.com
State/Province/Island Area
Zip/Postal Code
Which best describes your agency/organization

Other, please specify
Are you a SAMHSA Promoting the Integration of Primary and Behavioral Health Care (PIPBHC) recipient or provider organization?
PIPBHC State Recipient Name
PIPBHC Recipient Name
PIPBHC CoCM Recipient Name
PIPBHC CoCM Provider Organization Name
PIPBHC Provider Organization Name
PIPBHC States Provider Organization Name
Organization Name
Where is your organization in the process of integrating behavioral health and primary care?

Other, please specify
Is your organization a Certified Community Behavioral Health Clinic (CCBHC)?
Is your organization a National Council for Mental Wellbeing member?
Are you interested in joining the Center of Excellence for Integrated Health Solutions listserv?
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Supporting Your Team in the Collaborative Care Model: Lessons from the Field