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South Texas Ambulatory Research Network (STARNet) Enrollment Form PLEASE PRINT (INFORMATION PROVIDED WILL REMAIN CONFIDENTIAL AND VIEWED ONLY BY AUTHORIZED STARNET PERSONNEL) PART 1: Physician’s Contact Information:
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Document Date: 2010-03-24 18:05:01


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IndustryTerm

Internet access / clinical decision support tools / Web portal / clinical information systems / e-prescribing technologies / /

MedicalCondition

Allergy / disease / diabetes / /

MedicalTreatment

self-management / /

Organization

Institutional Review Board / Medicare / /

Person

Marisa F. Rodriguez / /

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Position

Physician / STARNet Coordinator / Coordinator / Practice Contact/Study Coordinator Office / /

ProvinceOrState

Alaska / /

Region

South Texas / /

Technology

Geriatrics / Health Information Technology / e-prescribing technologies / /

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