Complete the following form to join this learning community. If you have questions, please contact Meghan Clark (
) or Sue Armstrong (
), UAA Center for Human Development.
Which ECHO projects are you interested in?
Family ECHO: Challenging Behaviors (Children and Youth with Special Health Care Needs)
Opioid: Pain management and medication assisted treatment
Autism Behavior Technician
For example: MD, Pediatrician
Name of Clinic or Agency
Clinic or Agency Location
In the future, would you be interested in providing an ECHO case presentation?
Possibly, with additional information
If possibly or yes, which ECHO would you like to present for?
If you require accessibility accommodations to successfully participate in ECHO, please let us know 2 weeks in advance. I will need the following accommodations in order to participate:
Wheelchair access (if participating in person)
Send me a copy of my responses.
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