Prior to each week's ECHO Diabetes in the Time of COVD-19 webinar session, we invite learners to present cases for feedback to be discussed live with our expert multidisciplinary faculty during our session. We ask you to complete our case presentation form with information about your case so we can best guide the learning experience. When we receive your case, we will double check to make sure no protected health information has been provided and will then email you with a confidential patient ID number (ECHOID) that must be utilized when identifying your patient during the session. If selected for presentation, we will contact you on the Monday prior to the Wednesday session. Cases will be reviewed on first-come-first-served basis and we may not be able to discuss your case live; if that is the case, we will share your case with a designated faculty member in your state or a Stanford faculty member who may be offer additional guidance and support.

  • Please complete questions 1-42
  • You may save and return to this online form. In order to do this, you must write down the return code that is unique to your form. If you do not have this return code, you will be unable to return to the form that you had been working on.

PLEASE NOTE: NO identifying protected health information (PHI) will be presented at any time on this form or during the clinic case presentation.

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