Ohio MedTAPP Application

Thank you for your interest in MedTAPP, Ohio's Medicaid Technical Assistance & Policy Program. To become a member, please complete the application form below. Applications are processed within 5-7 business days.

The information you provide will be used to support healthcare delivery for people insured by Medicaid in Ohio. The information is shared with Ohio Medicaid staff, is subject to public records, and will be available to the public on https://www.grc.osu.edu/MedTAPP

User Contact Information

First Name

Last Name

Credentials

Email Address

Organization

Job Title

Phone Number

Hyperlink to Biography

Enter your preferred expertise tagline in the next question. See example below.

Please keep your preferred expertise tagline to no more than three subject matter areas or capabilities.

Tagline

Upload your headshot/ portrait photo.

Upload your curriculum vitae or biography if no hyperlink is available.

Do you have clinical expertise serving people insured by Medicaid?

Yes
No

Are you interested in achieving better outcomes for your patients, your practice, and yourself through quality improvement science initiatives?

Yes
No

Which of the quality improvement science capabilities apply to you and/or your practice? (Select all that apply.)

Data infrastructure to house and maintain clinical data
Data analytic capacity
Quality improvement coordination to facilitate practice-level transformation
Not applicable

5. Verification

Answering the captcha is required to proceed