Apply To Be A CHEPS Affiliate
To apply to be a CHEPS affiliate, please fill out and submit the form below. Once you've submitted the form, you will receive a follow-up email within three business days.
Name
*
First Name
Last Name
Title
Please upload a photo we can publish with your listing
E-mail
*
Website
Brief (2 - 3 sentences) bio/description of interests and expertise
*
Type of affiliation (Please check all of the following that apply)
College of Engineering
Medical School
School of Public Health
School of Nursing
School of Information
Ford School of Public Policy
Ross School of Business
Institute for Healthcare Policy and Innovation
Other unit (please specify below)
if you selected "other unit," please specify
Please indicate which categories best describe you
Faculty
Industry Affiliate
Practitioner/Clinician
Other (please specify below)
if you selected "other," please specify
Apply
If you have any trouble with this form, please contact:
cheps-contact@umich.edu
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