The code block below illustrates how one might use # and // as comments in your logic and calculations.

# Text can be put here to explain what the logic/calculation does and why.
if ([field1] = '1' and [field2] > 7,

	// This comment can explain what the next line does.
	[score] * [factor],

	// Return '0' if the condition is False.
	0
)

Working …

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit North American phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

Long-Term Care Rise ECHO Registration

Thank you for your interest in the Long-Term Care Rise ECHO series.

Please complete the information below to register for this series. For questions related to prior knowledge or current practice, please complete as applicable to your situation.

M-D-Y H:M

First name

* must provide value

Last name

* must provide value

E-mail

* must provide value

Phone number

* must provide value

Phone extension

Job title

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Please select your highest credential

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What is your area of practice?

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Primary care

Specialty care

Non-clinical

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Specialty or area of practice

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If other, please include your specialty

What is the name of the nursing home, assisted living, or long-term care facility in which you work?

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List here:

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Facility License Number or Facility ID

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How many beds does your facility have?

How many beds are occupied at your facility?

Country

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United States

Other

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If other, what country?

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Address 1

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Address 2

City

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State/Territory

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County

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Zip code

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Is the mailing address above your personal address or your work address?

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Personal address

Work address

Other

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Please indicate other address type

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Are you a Penn State Health or Penn State College of Medicine employee?

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Yes

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If yes, what department?

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If yes, what is your Penn State mailcode?

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I am a provider who sees patients.

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True

False

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Approximately how many patients are under your care?

Strongly disagree

Disagree

Neither agree nor disagree

Agree

Strongly agree

Access to specialist expertise and consultation is an important area of need.

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Access to specialist expertise and health professionals from other specialties is a benefit to my clinical practice.

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Access to expertise in pharmacology is a benefit to my clinical practice.

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Learning about complex chronic disease topics though participation in Project ECHO, is an effective way to enhance clinical knowledge and expertise.

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Case-based learning as the focus for discussion is an impactful way of learning.

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Didactic (lecture) sessions are an effective way to develop clinical knowledge and skills.

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Can you think of a situation where you may have struggled with how best to manage a patient or support a client?

* must provide value

Yes

Not applicable

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What topics are you interested in learning about in this ECHO series?

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I heard about Project ECHO from

Colleague

Event

Grand rounds

Penn State newsletter

Phone call

Postcard

Publication

Social media

Web search

Other

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If other, please describe

Have you participated in Project ECHO before?

Yes

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Click "Continue" to go to the next page and complete your registration

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