MISSOULA -VITAS QUALITY OF LIFE INDEX (MVQOLI)

Registration Form

There are no fees for using the Missoula-VITAS Quality of Life Index but we do ask that you register by providing your organization name and a contact person.

Registration assures that you receive notice of any updates to the Missoula-VITAS Quality of Life Index.

Registered users will also receive information on MVQOLI benchmarking efforts and the option to share and compare quality of life data anonymously with other users.

To Register  Please email Melanie Merriman, PhD, at touchst@ix.netcom.com with the following information:

Organization
Organization Name*
Organization Phone*
Type of Organization*
- Hospice
- Hospital
- Home Health 
- Long Term Care
- Other (please specify)
Other Type of Organization
Contact Person
Name*
First Last
Email*
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
MVQOLI Details
How do you plan to use the MVQOLI?*
- Patient Care
- Research
- Both patient care and research
- Other (please specify)
Other MVQOLI use
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MISSOULA -VITAS QUALITY OF LIFE INDEX (MVQOLI)

Organization

Contact Person

MVQOLI Details