2020-2021 IVI Membership Application (Individual)
Thank you for your interest in joining the Innovation and Value Initiative as an individual. Please complete the following membership application to start the membership process. Following the receipt of your application, IVI will send you confirmation of your application as well as an invoice to submit dues.

We look forward to working with you to create an open and collaborative environment that brings together the best ideas and methods to improve value assessment in a rapidly evolving healthcare marketplace.
Email address *
Stakeholder Sector *
Name (First and Last) *
Organization Name (If Applicable)
Phone Number *
Street Address *
Zip Code *
If relevant, please provide the name and email address of your assistant.
How did you learn about IVI? (Check all that apply) *
Please check the correct dues category: *
Thank you for your application! You should receive a confirmation email and an invoice within 7 business days. We look forward to working with you on our common mission.
Never submit passwords through Google Forms.
This form was created inside of Momentum Health Strategies LLC.