Onboarding

Onboardingcrncharity2022-02-18T15:43:21+00:00

Ready to Start? Onboard Here!

Quality Health Network will use the below information to set up your agency in the Community Resource Network Resource Directory.

Please know we will show you how to update and add additional information to your agency profile at the Admin Training.

Agency Name: *

Program Name (if applicable)

Your Name *

Your Email *

Main Office - Street Address *

Zip Code *

Main Office Phone Number *

Days/Hours of Operaion: *

Counties your organization serves: *

Organization Description and Specific Services offered (for CRN resource directory) *

Languages Spoken at your organization:

English

Spanish

Russian

Persian

Korean

Chinese

Japanese

Vietnamese

French

German

American Sign Language

Other

Is your Organization/Program a covered entity under HIPPA

Yes

Please describe in more detail, the services your organization provides. *

What is your organization's intended use of CRN? *

Sending Referrals

Receiving Referrals

More robust care coordination and data sharing with other organizations around clients

Case Management (Case Notes, Assessments, Appointments, Intakes, Document Storage, etc)

Detailed Reporting Needs

If you picked sending referrals above, please list the organizations in the community that you send referrals to.

If you picked receiving referrals above, please list the organizations in the community that send referrals to your organization.

Thank you for your onboarding form!

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Phone 970.248.0033
Email support@qualityhealthnetwork.org