AFHTO 2015 Working Groups

Thank you for your interest in participating in a working group to shape the content for the AFHTO 2015 Conference!

The theme for the 2015 Conference is Team-Based Primary Care: The Foundation of a Sustainable Health System. There will be seven concurrent streams (click here for descriptions).

Board members, clinical providers, patients and staff members of AFHTO member organizations are eligible to participate in one or all of the following working groups to:

Create one of the seven concurrent programs
Select “Bright Light” Award winners

Click here for the roles and responsibilities of working group members

Please complete the form below before April 7, 2015. AFHTO staff will be in touch to schedule working group meetings.

Question Title

* Contact Information

First name

Surname

Job Title

Phone #

E-mail

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* I am affiliated with the following AFHTO member organization:

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* Within this organization I am a:

Board member

Clinical provider

Patient

Staff member

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* Concurrent Session Working Groups:
The concurrent session program is being built around seven core streams. Participation in a working group requires a total of 4-10 hours of work between April and early June (click here for more details). If you are interested in joining a concurrent session working group, please indicate your selection below:

	First Choice	Second Choice	Third Choice
1. Population-based primary health care: planning and integration for the community	1. Population-based primary health care: planning and integration for the community First Choice	1. Population-based primary health care: planning and integration for the community Second Choice	1. Population-based primary health care: planning and integration for the community Third Choice
2. Optimizing capacity of interprofessional teams	2. Optimizing capacity of interprofessional teams First Choice	2. Optimizing capacity of interprofessional teams Second Choice	2. Optimizing capacity of interprofessional teams Third Choice
3. Transforming patients’ and caregivers’ experience and health	3. Transforming patients’ and caregivers’ experience and health First Choice	3. Transforming patients’ and caregivers’ experience and health Second Choice	3. Transforming patients’ and caregivers’ experience and health Third Choice
4. Building the rural health care team: making the most of available resources	4. Building the rural health care team: making the most of available resources First Choice	4. Building the rural health care team: making the most of available resources Second Choice	4. Building the rural health care team: making the most of available resources Third Choice
5. Advancing manageable meaningful measurement	5. Advancing manageable meaningful measurement First Choice	5. Advancing manageable meaningful measurement Second Choice	5. Advancing manageable meaningful measurement Third Choice
6. Leadership and governance for accountable care	6. Leadership and governance for accountable care First Choice	6. Leadership and governance for accountable care Second Choice	6. Leadership and governance for accountable care Third Choice
7. Clinical innovations keeping people at home and out of the hospital	7. Clinical innovations keeping people at home and out of the hospital First Choice	7. Clinical innovations keeping people at home and out of the hospital Second Choice	7. Clinical innovations keeping people at home and out of the hospital Third Choice

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* "Bright Lights" Awards Review Committee:
Participation in the review committee requires a total of 6-12 hours of commitment in August to September specifically to review and score nominations followed by a group teleconference to determine the award winners. Volunteers for the "Bright Lights" Awards Review Committee can sign up until May 29, 2015. If you are interested in joining this committee, please indicate below:

	Yes	No thanks
I would like to serve on the awards review committee	I would like to serve on the awards review committee Yes	I would like to serve on the awards review committee No thanks

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* Comments:
Please use this space to indicate additional interests, potential conflicts in your schedule and/or anything else pertinent to your role in the conference.

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* I have read the roles and responsibilities of working group members and, to the best of my knowledge, will be able to fulfill these duties in the timeframes indicated.

Yes

Thank you for your interest in developing the conference program!

Question Title

* Contact Information

Question Title

* I am affiliated with the following AFHTO member organization:

Question Title

* Within this organization I am a:

Question Title

Question Title

Question Title

* Comments: Please use this space to indicate additional interests, potential conflicts in your schedule and/or anything else pertinent to your role in the conference.

Question Title

* I have read the roles and responsibilities of working group members and, to the best of my knowledge, will be able to fulfill these duties in the timeframes indicated.

* Comments:
Please use this space to indicate additional interests, potential conflicts in your schedule and/or anything else pertinent to your role in the conference.