National Hypertension Control Roundtable

Organization Name*

Please select the sector that best describes your organization.*

Select

Contact Name*

Contact Title*

Contact Email*

What does your organization specifically want to gain from Roundtable membership?*

Select

If Other, please list

Using the four-point scale, please describe your organization's current involvement in the following activities. If the activities do not apply to your organization, please use Not at all.

Promoting health benefit designs that support improved hypertension screening and control*

Extremely

Very

Moderately

Not at all

Implementing evidence-based hypertension strategies, tools and resources.*

Extremely

Very

Moderately

Not at all

Promoting evidence-based hypertension strategies, tools and resources.*

Extremely

Very

Moderately

Not at all

Engaging in policy initiatives (i.e., educating decision makers, advocacy efforts, training) that can help improve hypertension screening and control rates.*

Extremely

Very

Moderately

Not at all

Implementing organizational policies that support hypertension control (i.e., food service guidelines, physical activity programs, tobacco free policies).*

Extremely

Very

Moderately

Not at all

Partnering with community resources to support patients in managing hypertension.*

Extremely

Very

Moderately

Not at all

Increasing awareness about the importance of blood pressure control.*

Extremely

Very

Moderately

Not at all

Please indicate if your organization is working to increase hypertension control through any of the following areas:*

Select

If Other areas, please specifiy

Please identify which of the following action teams are of interest to you.*

Select

Does your organization have hypertension control resources it would like to share with NHCR members?*

Yes (share links)

If yes, please share links

Please confirm your consent by checking the box below.*

I understand that registering as a National Hypertension Control Roundtable (NHCR) member allows NACDD to send general email communications about NHCR to me and allows NACDD to add my name, email address, organization name, and title to its database. I also understand that I can update my Communications Preferences to receive additional communications or opt-out of receiving NACDD communications at any time.

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