Virginia Association for Healthcare Quality

VAHQ Annual Membership ($50.00) - Join VAHQ.org
Select a Payment System	Paypal/Credit Card - Secure credit card payment Offline (check) - Offline (check)
Coupon Code
Member Status	New Renewal
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Choose a Login Name (User ID) It must be 4 or more characters in length and may only contain small letters, numbers, and the underscore '_'	check for uniqueness
Your E-Mail Address A confirmation email will be sent to you at this address. IMPORTANT: This is the e-mail address where all official VAHQ communications will be sent.
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Title
Organization
Preferred Address	Home Work
Street
City
State
ZIP
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Work Phone
Home Phone
Fax
Professional Organization
Primary Work Area	Quality Performance Improvement Utilization Management Risk Management Infection Control Data Analysis / Decision Support Health Information Management Patient Care Other:
CPHQ Certified?	CPHQ Certified Not Certified Yet
NAHQ Member?	I am an NAHQ Member I am Not an NAHQ Member
Committee Interest?	Yes No
Board Member Interest?	Yes (Must be an active member for 1 year) No
I do not want my information shared with VAHQ.
Conference Preferences
Vegetarian Meal:	Yes No
Special Seating Accomodations:	No Yes Wheelchair Service animal
Referred by: