OHA COVID-19 Therapeutics:Office Hours Request Form

OHA COVID-19 Therapeutics:

Office Hours Request Form

This form is intended for providers to schedule meeting time with representatives of the OHA COVID-19 Therapeutics team. Please use this form if you have a topic to discuss or a request to fulfill that cannot be accommodated with current OHA resources & processes.

OHA has reserved time for Office hours on Mondays, from 2:00 PM - 2:30 PM PST. Please include a special note if you need to meet outside of this timeframe.

Facility Name*

Name of the Provider Site / Practice

Requestor Name*

Please enter your first and last name.

Email Address*

This is the email address to receive the meeting invitation from OHA. Virtual meeting will be scheduled over Microsoft Teams. You may forward the meeting invitation to colleagues in your practice as needed.

Topic*

Reason for meeting with OHA COVID-19 Therapeutics Logistics team.

Select

Topic / Issue (Other)

Office Hours Date Request*

Office Hours will be held Mondays from 2:00 PM - 2:30 PM PST. You can request an alternative date if this time slot does not work for you.

Select or enter value

Alternative Date Request

OHA Cannot Guarantee your request will be accommodated. Please monitor your email inbox for an email coordinating a meeting time.

Notes & Comments for Alternative Date Request

Brief note for why Mondays 2:00 - 2:30 cannot be accommodated.

Send me a copy of my responses

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