Registration Form - PH-SS Office Hours 10-8-2026

Register for PH-SS Office Hours
10/08/2026

Please complete the form below to register for this webinar.

After submitting your registration, you’ll receive a confirmation email with your webinar details and Zoom link.

If you have any questions, please contact: ccbhc-ta-hub-ks@acmhck.org

measures What Name

Name *

First

Last

Email address *

What is your role at your organization? *

Which state is your clinic located in? *

What is the name of your CCBHC clinic? *

Is there a specific measure you suspect your clinic needs support with documenting, calculating or reporting? *

Do you have any specific questions or topics about clinic-collected measures that you would like addressed during office hours? *

What questions would you most like answered during this session? *