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LEND / Specialty Clinics / ECHO / Contact / Give

© 2021 University of Washington | Seattle, WA

Center Of Excellence

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

ECHO Autism WA Purple

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

ECHO Autism WA Orange

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

ECHO IDD - Psychiatric Care

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

ECHO IDD - Resource & Resource Navigation

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

ECHO IDD - Next Step

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

ECHO IDD - Intro

Name

First Last

Email

Consent

I agree to the program conditions of participation

By registering, you confirm your acknowledgment for the expectations for participation in the Primary teleECHO™ clinic – Participate in at least 70% of the teleECHO™ sessions and are interested and willing to present a client’s case for discussion, appropriate to the focus of the program. We also request participants to actively engage in the peer learning and teaching community by sharing ideas in breakout and large group discussions.

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