Oklahoma Physician Interest Form
Share your perspective on how patient needs are identified, referred, and supported beyond the exam room.
Full Name
*
First Name
Last Name
Credentials
*
Please Select
MD
DO
Other
Practice / Organization
City / Region of Oklahoma
*
Primary Area of Practice / Specialty
*
Practice Setting
Independent/private practice
Health system or hospital
Rural practice
Tribal health
FQHC/community health center
Direct primary care/cash-pay
Academic
Other
Do you currently care for patients with chronic health conditions?
*
Yes
No
Which of the following do you encounter in your patient population?
Nutrition-related concerns
Diabetes/metabolic disease
Cardiovascular disease
Obesity/weight-related conditions
Food insecurity
Social/community resource needs
Frequent healthcare utilization
Preventive health needs
Other
Would you be willing to participate in a brief conversation with Truth in Health about how these needs are assessed, referred, supported and followed in real-world practice?
*
Yes
Possibly, please tell me more
No
What is one issue involving referrals, nutrition resources, community resources, patient education, or care coordination that you believe Oklahoma should better understand?
Best Email Address
*
example@example.com
Best Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
How did you hear about this project?
Truth in Health member
Professional colleague
Social media
Truth in Health communication
Other
Name of the person who referred you
Thank you for lending your perspective.
Understanding what happens at the point of patient care is essential to identifying what is working, where connections may be missing, and what questions deserve further study.
Submit
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