2019 Functional Group Membership Form

Per the Orders of Conduct, the Functional Group annually reassembles a new voting body. As participant, you may choose your level of involvement – either as a Voting OR Guest member – and it is effective for one year.

  • As a Voting Member, you are expected to attend all Functional Group meetings and be an active participant in group activities.
  • As a Guest Member, you may participate in the Functional Group meetings but will not have voting privileges.

Please complete and submit the following Functional Group Membership form by January 31, 2019 In addition to identifying your membership status, it allows us to update our email list. If you do not complete this form by January 31, you may not be eligible to participate as a Voting Member of the Functional Group(s) for the entire year.


DIRECTIONS:

For each Functional Group, please check the appropriate box to choose your desired 2019 membership status. You may participate as either a Voting or Guest member.

Planning and Outreach

Patient Management