Population Health Management Rotation Application

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

LSU Email*

Alternative Email*

Cell Phone*

Current Academic Program*

Anticipated Graduation Date*

Undergraduate Degree*

Graduate Degree*

Briefly describe your interest in Population Health Management*

Rate your understanding of how to use quality improvement methods and tools*

Rate your knowledge of Managed Care Organizations*

Rate your knowledge of Population Health Management*

Requested Block # (1st choice)*

Requested Block # (2nd choice)*

Upload your resume*

Accepted file types: doc, docx, pdf, jpg, png, rtf, Max. file size: 50 MB.

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