Patient Case Form
If you would like to present a case, please fill out the form below:
*Please do not include any patient identifying information on the form.
Why Case Based Learning?
Submitting a case for presentation and discussion is an integral component in the Project ECHO model as it is critical to building competency and sharing knowledge. All cases are welcome whether they are common clinical scenarios or more complex and challenging presentations.
When presenting a case, you enhance your learning and your colleagues! Past participants tell us that they learn the most from teleECHO sessions when they present their own cases.
ECHO clinics are a respectful and safe environment free of criticism and judgment. Our team prioritizes your learning experience and improvement in your level of specialty care through patient case discussions.
How it works
When you register for your session, you will be assigned a date during the sessions to present a case. If the assigned date is not convenient, please contact firstname.lastname@example.org, and we’ll work with you to find another date that is agreeable.
The case can be your own, a colleagues, or a particular situation where you have had a question about a particular patient. The case you present does not have to be your own patient!
Remember, ANY level of provider can present a case during ECHO clinics and a single provider can present multiple cases for their facility.
Please do not use any personal health information during your case presentation (i.e. name, date of birth, or even job position if it can be used to identify them).