Joining My InnerView

Champion continuous quality improvement in your organization by knowing where you’ve
been, where you are and where you’re going. Sign up today to begin your evidence-based
path to quality!

Multi-Facility Organizations
A “multi-facility” organization is any group (two or more) of facilities
under common ownership

A designated individual at the corporate level should complete the “Join” function for their entire organization.

A representative from My InnerView will then schedule training on the system with the contact person.

If your organization will not be joining as a group, continue joining by following the instructions for an individual facility.
Individual Facilities
An “individual facility” is any facility
that is NOT part of a
multi-facility organization

OR

Is part of a multi-facility organization
which is NOT joining as a group.

Complete the form below to submit your facility’s information.
 
Questions?
E-mail us: info@myinnerview.com
or call (715) 848-2713

Choose your membership options

Type of Membership:


Provider type: Number of facilities
Adult Day Services

Assisted Living

Home Care

Hospice

Independent Living

Skilled Nursing

Other

Not Applicable

Designate your contact person

The person submitted as “Contact Person” will become the facility’s Superuser and have the ability to perform a variety of functions that no one else in the organization can.

Salutation:
First Name:
Last Name:
Title:
Organization:
 The person designated as “Contact Person” will become the Superuser and manage the administrative functions for your facility or organization.

There is only one Superuser per multi-facility organization or individual facility (see definitions above). The Superuser will have the responsibility of getting your facility (or facilities) online.
Address:
City:
State:
Zip:
 -
Phone Number:
Ext:
Fax Number:
E-Mail Address:

Assign a user name and password

A user name and password will give the Superuser access to the system once your membership is
approved.

User Name:
 
Password:
 
Password (again):
 Choose a user name specific to your facility or organization (ABCCorp1, for example) — not the person. The user name cannot be changed once it is submitted.

You’re almost finished!

Let us know how you heard about us, read our Acceptance Agreement and click JOIN. We will contact you soon!

How did you hear about us? :
I have read and accept the above agreement