TREAT Program Registration Form

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upa9n4cmVkDhiTFeIH6YEYewwTUdUy4CuBfrVD7dehRh8SB8mpdboIU4kF6p4kgXfFEqIowD5FDTCLqsaTWkNn32TpGnzjFFTob

The TREAT (Training, Response, Education, Access, Treatment) Program (formerly IN-HAMP) is a comprehensive medical education training designed for clinicians who are new to treating hepatitis C, as well as those interested in expanding their knowledge of HIV pre-exposure prophylaxis and substance use disorders.

This one-day training equips clinicians with the skills, resources, and confidence needed to begin providing evidence-based hepatitis C treatment immediately following program completion and use a syndemic approach to care.

Throughout the day, participants will receive practical instruction on diagnosing and managing hepatitis C, understanding HIV prevention and care considerations, and integrating person-centered care strategies for SUD into clinical practice.

Training includes expert-led presentations, case-based learning, and opportunities for discussion with faculty experienced in viral hepatitis and infectious disease care.

A sample agenda is below:

Indiana hepatitis C and HIV epidemiological profile
A comprehensive approach to HCV: workup for the non-specialist
HCV medication access: What you need to know
The new era of direct-acting antiviral treatments
HIV management for the primary care provider
Prescribing pre-exposure prophylaxis
The importance of person-first language
Treating the syndemic: HIV, HCV, and substance use disorder

Note: If you have previously attended an IN-HAMP training you are welcome to participate in the TREAT program for a full or half day.

Which training would you like to register for?

In-person events take place at the Health Sciences Building on the IU Indianapolis campus:

1050 Wishard Blvd.
Indianapolis, IN 46202

Breakfast, lunch, and parking are provided.

Note: In-person events that do not reach the minimum required number of registrants will be converted to a fully virtual format.

HealthLinc Resident Only - Wednesday, June 10 (Reiner Center - Family Medicine, Pharmacy, Nursing)

HealthLinc Resident Only - Thursday, June 11 (Northwest Porter Hospital - Internal Medicine)

Thursday, July 30, 2026 | Hybrid (virtual and in-person)

Thursday, September 10, 2026 | In-person only

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Are you a resident or faculty member?

Resident

Faculty

Other

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Please describe "other"

Did the individual attend the training?

Yes

Yes - Attended without registering

Sponsor representative

TREAT presenter

ECHO Member

Check if the participant indicated they are no longer able to attend

No longer able to attend

Reach out in the future regarding attending

Original sign up date: March 18, 2026

The July 30, 2026 training will be offerred in-person and virtually. Please indicate how you would like to participate:

In person: 1050 Wishard Blvd. Indianapolis, IN 46205

Virtually: Zoom

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Have you previously participated in an IN-HAMP training?

Yes

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Do you wish to participate in the full day or just the HIV portion of the day?

Full day

Introduction to HIV/SUD portion only (last half of the day)

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Do you have any dietary restrictions (allergies, vegetarian, etc.)?

Yes

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What is your dietary restriction(s)?
Select all that apply

Lactose intolerance

Celiac disease

Vegetarianism

Veganism

Kosher

Keto

Diabetes

Dairy-free

Low carb

Food allergies (please list below)

Other (please list below)

What are your allergies?

Other dietary restrictions

First Name

Last Name

Pronouns

Professional degree(s)

Profession

Please list your profession here

Date of Birth

M-D-Y

Organization Name

Organization Street Address

Organization City

State

Zip Code

County (IN)

County (Outside Indiana)

Are you currently providing direct care to patients?

Yes

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Would you like to receive continuing education credits?

Continuing education credits will be provided at no-cost through the Division of Continuing Education in Healthcare Professions at the IU School of Medicine. Credits offered will include the following:

Physicians: AMA PRA Category 1 Credits™.
Pharmacists: ACPE contact hours.
Nurses: ANCC contact hours.
Physican Assistants: AAPA contact hours

Credit is commensurate with the time attending the activity.

Yes

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In support of improving patient care, Indiana University School of Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the health care team.

Under the Joint Accreditation (JA) guidelines, IU School of Medicine can award credit to physicians, nurses, and pharmacists through a single, unified application process and set of accreditation standards. IU School of Medicine can also provide verification of attendance to other members of the health care team, including dentists, dietitians, optometrists, physician assistants, psychologists and social workers.

The TREAT program receives support from industry partners like AbbVie and Gilead. Do you consent to having your contact information (name, email, profession, and organization name and address) shared with the program sponsors?

Please note that sponsors play no role in continuing education content.

Yes

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Have you ever participated in the HIV or HCV ECHO program?

HIV ECHO

Hepatitis C ECHO

None

Would you like to receive information about the Hepatitis C ECHO?

Yes

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Would you like to receive information about the HIV ECHO?

Yes

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Do you currently treat patients diagnosed with hepatitis C?

Yes

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Do you currently treat patients diagnosed with HIV?

Yes

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How did you hear about the TREAT Program?

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