Join the Coalition

Ohio Person Centered Care Coalition

Become a registered member of the coalition

Register for information about upcoming events or to get more intimately involved with the coalition. This registration form was designed to help coalition leaders manage participation efficiently and get participants involved in areas where they have demonstrated interest. Please take a few minutes to complete this questionnaire. Make sure to hit the "Submit" button at the bottom of the page when you are done. This will ensure your inclusion on the PC3 listserv where you will receive important information about PC3 activities.

Your Information

Is this an individual membership or an organizational membership? *
Individual/Organization name:
* We may post members on the website
First Name *
Last Name *
Job Title *
Address *
City *
State *
Zip *
Email *

Other Disciplines:
Interested in working with the following committee(s):

I would be willing to be a guest speaker at future coalition conferences (or other educational offering).
Topic of Speech:

* = required

Contact Us

PC3 Coordinator
Office of the State Long-Term Care Ombudsman