Apply for PHASE and TC3 Motivational Interviewing – Community of Practice


If you have any questions, please email us prior to the application due date, December 2, 2019.

How to Apply

Step 1: Review Informational Webinar (Optional)

Interested organizations are encouraged to watch the webinar recording that is posted below. The webinar reviewed the Community of Practice components and answered questions that attendees had. Slides can be found here.

Step 2: Submit Application Form

Please apply via the online form below by Monday, December 2, 2019 at 5pm PT. Upon reviewing applications, we may ask for follow-up information or a phone call with the applicant team lead or other leadership staff. We intend to select 5 qualified and strong organizations for this Community of Practice. The CoP will be announced via email by Friday, December 13, 2019.

Please ensure you include the following documents in addition to the completed online application form (if you have trouble downloading either template, please email Nikki):

  1. Organization narrative responsedownload the narrative questions
  2. Facilitator narrative response (one per facilitator – 2 or 3 per organization): – download the facilitator narrative questions

PHASE and TC3 Motivational Interviewing Community of Practice Application Submission Form

PHASE and TC3 are programs of the Center for Care Innovations and funded by Kaiser Permanente. 

Please submit your application by 5 pm PT on Monday, December 2, 2019. Please refer to the PHASE and TC3: Motivational Interviewing Community of Practice Request for Applications (RFA) for details about the CoP and application requirements. 

Your Organization Information

Lead Contact for the MI CoP

Please speak with a senior leader at your organization about this CoP. If they understand the time commitment and are supportive of your participation in the CoP, please fill out the information below.


Each organization can send 2 or 3 individuals to the MI CoP. There is an expectation that the organization send the same 2 or 3 staff to the MI sessions and conduct MI workshops with your staff. If you are part of a consortium, MI facilitators would conduct MI workshops with staff at your member health centers. 

Please provide information below on the 2 or 3 individuals you have selected to participate in the MI CoP. Please have them fill out the Facilitator Narrative Response attached below and submit with this form. 

Application Components