TOGETHER 2 GOAL® AND JOHNSON & JOHNSON CORE PROGRAM APPLICATION

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Principal Corporate Collaborator Johnson & Johnson Healthcare Systems is providing free on-site training for up to three Together 2 Goal® participating
organizations in 2018. Called the CORE program, this interactive one-day training is designed to help you get to goal.

During this program, participants will spend a day in the life of a diabetes patient and will gain insight in order to provide better care. Last year’s
participants shared their favorite parts of the program:

In order for your organization to participate, you must be able to dedicate 25-40 staff to a one-day, in-person training with healthcare providers from different disciplines.

To be considered for the program, please submit the below application by January 31, 2018.

For questions, please email together2goal@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 *
(Maximum characters: 2000)
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Diabetes Population Identification: Define your diabetes population and how you identify them. *
(Maximum characters: 2000)
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How many patients with diabetes do you serve? *
Management of Patients with Diabetes: Describe your current programs. *
What resources or tools are you currently using? *
Challenges and Obstacles: What challenges or obstacles have you encountered with management of patients with diabetes? *
Goals: What do you hope to gain or learn from this training? *



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