Join the iCoDE Consortium

Thank you for your interest in joining the iCoDE Consortium. Members help manage updates to our reports, create new resources, plan and participate in iCoDE meetings, and support implementation and dissemination efforts. Please provide us with the information below, and we will do our best to reach out to you in a timely fashion. Note on personal data: We do not sell or share your data with anyone. Your registration data are stored in a secure, online database hosted by the West Coast Consortium for Technology & Innovation in Pediatrics (CTIP). We use the information for impact and dissemination tracking. We will never share your information without your explicit consent.

Name

First and last. Feel free to include any degrees or titles, e.g., "Juan Espinoza, MD"

Organization

Role or Title

Sector

Which of the following describe your organization? Select all that apply.

How did you here about the iCoDE Project?

Select all that apply.

How you heard - details

If you can, tell us a little more about how you heard about iCoDE (for example, what website or article brought you here?)

Professional Background

Which of these describe you? Select all that apply.

Tell us about yourself

In a few words, tell us about you, your interest in iCoDE, and any relevant skills or experience that you might contribute.

CV (optional)

This is not required, but you can choose to upload a copy of your CV.

Attach file

Drop files here

Would you like to receive iCoDE updates?

As we release updated version of iCoDE and new resources, would you like us to notify you? We will never sell or release your information to anyone else.

Yes, use my email to send me iCoDE updates.
No, Thank you.

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