Eligible providers must submit a Letter of Intent for each DAP Program provider type they wish to participate in. An LOI is required in order to participate in the program. If you intend to participate, please complete and return the appropriate LOI template(s) below and send to by April 1, 2022.
Provider types eligible to participate in the social determinants of health HIE incentive must complete and return the SDOH Closed-Loop Referral (CLR) Form and SDOH CLR Spreadsheet below and send to firstname.lastname@example.org by April 1, 2022.
If you have questions about the DAP Program for CYE 2023 as it relates to HIE milestones or SDOH milestones, or if your organization has not yet signed an Arizona HIE Participation Agreement, please contact email@example.com.