TOGETHER 2 GOAL® AND JOHNSON & JOHNSON CORE PROGRAM APPLICATION

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Principal Corporate Collaborator Johnson & Johnson Healthcare Systems is providing on-site, interactive trainings for up to three Together 2 Goal® participating organizations in 2017 as a free campaign offering to help get you to goal. Please submit this application by January 31, 2017 to be considered.

Applying organizations must have the ability to dedicate 25-40 staff to a one-day, in-person training with healthcare providers from different disciplines.

For questions, please email t ogether2goal@amga.org with the subject line “Together 2 Goal CORE Program Application Questions.”

Name: *
Organization: *
Email: *
Organizational Profile: Please Provide a brief organizational profile that gives the reader an understanding of the size and scope of your organization *
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Diabetes Population Identification: Define your diabetes population and how your identify them. *
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How many patients with diabetes do you serve? *
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Management of Patients with Diabetes: Describe your current programs. *
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What resources or tools are you currently using? *
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Challenges and Obstacles: What challenges or obstacles have you encountered with management of patients with diabetes? *
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Goals: What do you hope to gain or learn from this training? *
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