Five-Hospital Cohort Application

Please have all information ready ahead of time to cut-and-paste it into this form. This form cannot be saved.

Organization Information
Main Contact's Information

Upload word document here

Thank you for taking the time to plan your participation in this program. When you hit “submit,” you will receive an email confirming your application and listing your response. If you notice a mistake, please send an email with the correction to healthcareradvisors@purdue.edu.

Contact

Melanie Cline
Melanie Cline
RN, MSN, LPC
Senior Advisor-Lean Healthcare
317-481-9398
317-389-0530
cline3@purdue.edu

  

 

 


*Funding for this project was made possible by Flex funding, HRSA Grant # H54RH00042, from the Department of Health and Human Services Health Resources and Services Administration (HRSA) to the Indiana State Office of Rural Health.

Purdue University, West Lafayette, IN 47907 (765) 496-1911

© 2014 Purdue University | An equal access/equal opportunity university | Copyright Complaints

If you have trouble accessing this page because of a disability, please contact Purdue Technical Assistance Program taphelp@purdue.edu.