Alliance for Better Health Performance Team Identification

Alliance for Better Health Performance Team Selection

Please list your organization and contact information below.

1. Organization name *This question is required.

2. Name of organizational contact *This question is required.

3. Email address *This question is required. This question requires a valid email address.

4. Phone number *This question is required.

Please check the box next to each Performance Team that your organization is participating on and indicate the name and contact email for the participant who will represent your organization. If multiple people from your organization should be on one team, please indicate the additional people in the 'Other Participants box'.

Space Cell	Check if Participating
Avoidable Hospital Use Performance Team	Avoidable Hospital Use Performance Team: Check if Participating
Preventive Health Performance Team	Preventive Health Performance Team: Check if Participating
Asthma Performance Team	Asthma Performance Team: Check if Participating
Behavioral Health Performance Team	Behavioral Health Performance Team: Check if Participating
PAM (Patient Activation Measure) Performance Team	PAM (Patient Activation Measure) Performance Team: Check if Participating
Palliative Care Performance Team	Palliative Care Performance Team: Check if Participating

Avoidable Hospital Use Performance Team

Participant Name - (Avoidable Hospital Use)

Participant Email - (Avoidable Hospital Use)