First Name
*
Last Name
*
Email
*
Functional Role
*
ADNS/ADON
Clinical Consultant
Corporate Clinical Director
Dietitian
DNS/DON
Executive Director/Administrator
Health Information Specialist
Infection Preventionist
LTC Service Provider/Vendor
Nurse Assessment Coordinator/MDS Coordinator
Nurse Consultant
Occupational Therapist
Other
Other MDS/RAI Professional
Other Nurse Executive
Physical Therapist
Quality Improvement Professional
Rehabilitation Nurse
Reimbursement Specialist/Corporate Consultant
Social Worker
Speech Therapist
Staff Development Educator
Staff Nurse
State
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
GU
PR
VI