Clinician Champions in Comprehensive Antibiotic Stewardship
Please complete this form if interested in joining the Clinician Champions in Comprehensive Antibiotic Stewardship (CCCAS) Collaborative - A joint effort of Health Care Without Harm (HCWH), the Pediatric Infectious Disease Society (PIDS) and the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) group.
Members will be added to the Collaborative email list to receive updates on quarterly meetings, policy actions, and emerging research and developments in the field of antibiotic stewardship.
Name *
Credential *
Job Title *
Place of practice
Professional organization affiliations (if applicable)
ex: American Medical Association, American Public Health Association Committee X, Peer Listserv names
Facility organization affiliations (if applicable)
ex: Acme Hospital, Acme Health Center
Location: City, State, Zipcode *
Email address *
Phone
What interests you about joining the CCCAS Collaborative?
Would you like to receive news and other emails about: *
Required
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