WYFI Champion Interest Form
The Wyoming Department of Health (WDH) wants to identify health care professionals across the state
who are interested in becoming a Champion for the Wyoming Frontier Information Health Information
Exchange (WYFI).

A WYFI Champion’s role is to help advance the goals of WYFI by engaging and educating other healthcare
partners on the benefits of becoming a participant of WYFI. The Champion may be a healthcare
professional from a range of settings – from the provider, clinical ancillary staff, administrative, technical to
an association level. A WYFI Champion believes in the goals of WYFI to improve care coordination and
health outcomes, and therefore volunteers to be a partner of and advocate for WYFI.

The WYFI team, inclusive of WDH and subcommittee members, will collaborate and coordinate with
Champions on efforts to promote WYFI across Wyoming communities. The WYFI team will equip
Champions with knowledge and resources on the functions, uses, and overall vision of the WYFI technology
solution. The Champions will provide their experience and insight they may have gathered from their WYFI
outreach. The role of WYFI Champions is truly valuable as they are trusted partners in the community.

If you are interested, please send your contact information to the WYFI Team and we will contact you with
further information on becoming a Champion.

Email address *
Your answer
Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
Profession/Role in Organization *
Your answer
Additional Comments or Questions?
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of State of Wyoming. Report Abuse - Terms of Service