Please note that there are certain conditions which must be agreed to if you are selected to participate in this ECHO program. Please indicate if you agree with the following statements (all must be agreed to):

The statement of collaboration may be downloaded by clicking here

• Patient Relationship Disclaimer: ECHO case presentations do not create or establish provider-patient client relationship between any Hub Clinician and a patient whose case is presented.
• Commitment to Collaboration: Recommendations from the Hub do not in any way replace my own diligence and professional expertise with respect to my patients or clients
• De-identified Information Notice and Confidentiality: Personal identifying information is not to be shared during ECHO sessions. If this does occur, I'll follow my own organization's policies and procedures to address the privacy breach.
• Participation Notice: I and/or my organization (Spoke) will participate in as many sessions as possible during the curriculum to maximize my learning experience. I understand that case discussions are part of every session and that I, or a member of my team, will be expected to present at least 1 (one) deidentified patient case.
• Recording, Photographs and Guests: The ECHO team records sessions for educational purposes and occasionally takes photos for promotional purposes. I give permission for my photos to be used unless explicitly requested in writing.

In order to support the growth of ECHO, Project ECHO® collects participation data for each ECHO™ program. This data allows Project ECHO to measure, analyze, and report on the reach of ECHO. It may be used in reports, on maps and visualizations, for research, for communications/promotions and surveys, for data quality assurance activities, and for decision-making related to new initiatives.