How would you like to leverage the Upfront & Northwestern partnership?

The form is 12 questions and should only take 5-10 minutes to complete. Thanks in advance! 

First Name

Last Name

Email

Outreach purpose

Target population

Outreach volume and frequency

Please define program metrics desired upon completion of outreach.

Please define content/status and marketing approval status.

Define analytics support required.

What information needs to be documented in patient chart?

Are there requirements beyond documentation (e.g. epic work bench)?

Is outreach data required to feed into EDW report?

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