Add Membership First Name* Last Name* Email Address* Title / Job Duty* Work Phone Number* Type of Organization or Facility* Select Option Below Acute Care Hospitals (Core HCC Member) Behavioral Health Services and Organizations Community Emergency Response Team and Medical Reserve Corps Dialysis centers and regional Centers for Medicare and Medicaid Services (CMS)-funded end stage renal disease networks Emergency Management Organizations (Core HCC Member) EMS (Including inter-facility and other non-EMS patient transport systems; Core HCC Member Federal facilities (e.g. US Department of Veterans Affairs Medical Centers, Indian Health Service facilities, military treatment facilities Home Health Agencies(including home and community based services) Infrastructure companies (e.g. utility and communication companies) Jurisdictional partners, including cities, counties and tribes Local chapters of health care professional organizations (e.g. medical society, professional society, hospital association) Local public safety agencies (e.g. law enforcement and fire) Medical and device manufacturers and distributors Non-governmental organizations (e.g. American Red Cross, voluntary organizations active in disaster, amateur radio operators, etc.) Outpatient health care delivery (e.g., ambulatory care, clinics, community and tribal health centers, Federally Qualified Health Centers, urgent care centers, free standing emergency rooms, stand-alone surgery centers) Primary care providers, including pediatric and women's health care providers Public Health Agencies (Core HCC Member) Schools and universities, including academic medical centers Skilled nursing, nursing, and long-term care facilities Specialty patient referral centers (e.g., pediatric, burn, trauma, and psychiatric centers) Support service providers (e.g., clinical laboratories, pharmacies, radiology, blood banks, poison control centers) Other (e.g., child care services, dental clinics, social services, faith-based organizations) Other If "Other" please specify Name of Facility / Organization* Facility / Work Address* City* Zip Code* County* Alachua Bradford Columbia Duval Gilchrist Lafayette Marion Putnam Suwannee Baker Clay Dixie Flagler Hamilton Levy Nassau St. Johns Union Please select atleast one County