AZ Activity Application

For Vendors

Strategic business relationships are essential for providing quality patient care. This includes relationships with industry representatives, including but not limited to, medication and device sales representatives. There are many laws that govern these relationships. The CORE Institute has implemented policies and procedures to assist with compliance as situations arise involving these relationships.


Industry representatives interested in meeting with The CORE Institute staff and/or providers can complete this Activity Application, providing details of their product/service and the type of activity they are requesting. A quality and compliance review will be conducted. The outcome of the review is shared with the requesting party as well as those requested to participate.


Industry representatives are prohibited from providing gifts or remuneration (i.e. thank you for your business treats). Meals may be provided during educational events with prior approval through the Activity Application process.


Please complete the Activity Application in its entirety. This includes informational resources. Incomplete applications will be denied.


Please contact the Quality Department with any questions at 866.974.2673.

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Name of person submitting the application


Industry Representative Information

Company representative requesting activity

Phone

Product or Service Information

Articles, website links, etc.

Pamphlets, brochures, marketing material, articles, etc.

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Activity Information

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