Breaking the Rules for Better Care 2023 Interest Form

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* 1. Name

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* 2. Email

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* 3. Organization

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* 4. Please indicate if you are interested in joining the Breaking the Rules for Better Care Coalition(BTR).

Yes, I am ready to break some rules!

No, I am not interested at this time.

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* 5. If you have colleagues that are interested in joining the BTR coalition, please share their names and emails below. You can add more than one person below.