IHI Open School Chapter Enrollment Form
Thank you for your interest in the IHI Open School! To formalize your involvement with us and launch a Chapter, fill out the form below and we'll follow-up with important information and key resources to help you get started.

Prior to completing this form, we recommend that you visit our Chapter Map to see if your university/organization already has a Chapter - http://www.ihi.org/IHIOpenSchool/Chapters/Pages/ChapterDirectory.aspx. If so, you can connect with them directly through the map.

Questions? Let us know at openschool@ihi.org.

University/Hospital/Organization Name *
Your answer
City/State/Province/Country *
Your answer
Please select the option that best describes your Chapter setting. *
Mark only one oval.
How did you learn about the IHI Open School? *
Mark only one oval.
Why you are interested in starting a Chapter? *
Check all that apply.
Required
Please select the professions currently represented in your Chapter: *
Check all that apply.
Required
Do you plan to include other professions in your future Chapter? *
If yes, which professions?
Your answer
Does your school/institution have a formal quality improvement or patient safety curriculum? *
This may include a formal course, elective, practicum or quality improvement projects, grand rounds, and so on. Mark only one oval.
If yes, please tell us briefly what this is, if IHI Open School content is used, the year it began, and who we may contact at your institution regarding this curricula (if known).
Your answer
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