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Perinatal Quality Collaborative of North Carolina

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Comprehensively Lessening Opioid Use Disorder Impact Letter of Intent

Our facility is interested in joining the Comprehensively Lessening Opioid Use Disorder Impact initiative.

PLEASE NOTE:  This is NOT a registration form for your team and completing this form will NOT register your team for the initiative.  It will ensure that you receive timely information as the initiative nears launch including including requirements for the initiative and the link to register your team if you decide to participate

Use the following format provide introductory information about your team and to ensure you are kept informed.
5. Our unit has a QI team. *This question is required.
6. Our team has an active family member. *This question is required.
7. Our team has a member of senior leadership. *This question is required.