Community Partnership Participation Agreement
The most effective way to impact health care is to align efforts with those who have common goals. Under contract with the Centers for Medicare & Medicaid Services, Mountain Pacific works with local, state and national partners to achieve quality improvement—and you will benefit and learn from these efforts! We look forward to partnering with you to improve outcomes and thank you for your commitment to quality.
Please provide the requested information below to participate in our programs.
If you prefer to print and sign this participation agreement, below is a blank copy of this form that can be printed. Once completed, you can email a signed copy to your account manager or ealm@mpqhf.org. The form can also be faxed to (406) 513-1920 or mailed to Ericka Alm at P.O. Box 5119 Helena, MT 59604.