Activate an optimized version of the page designed specifically for screen readers.
Outdated browsers can expose your computer to security risks. To ensure a secure experience, we recommend updating to the latest browser version. Support for this browser version will soon be discontinued.
Request to Participate in the 2018 /2019 National A3 Collaborative
Download the A3 Collaborative Participation Package for complete details.
Contact Information - Submitter
Contact Information - Team Lead
Please Provide the Type of Organization Your Team is Representing
Please select from the list below)
Hospital/Health-system - Teaching
Hospital/Health-system - Non-teaching
Convener organization (for example, QIO, state pharmacy organization)
FQHC/other community health center or clinic
Skilled nursing facility
Accountable Care Organization
Health plan/insurance provider
Powered by Qualtrics