State Flex Program Contact Information Form

The Technical Assistance and Services Center (TASC) maintains lists of Flex Program contacts on behalf of the Federal Office of Rural Health Policy (FORHP). The lists are used to facilitate communication between state Flex Programs and to distribute important information. Please complete this form to add or change a contact.

If you need to remove a contact, please email the name and state to Nicole Clement at

Please direct questions to Nicole Clement at

Contact Details
Flex Profile Information
Please complete this section if you want this contact listed our your state's Flex Profile page. At a minimum, please provide the contact's title and indicate if they fill a Flex Program role.
Please include the month and year.
Maximum size of 5 MB.
Files must be less than 5 MB.
Allowed file types: gif jpg png.
Please enter the words you see below to help us prevent spam submissions.

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number UB1RH24206, Information Services to Rural Hospital Flexibility Program Grantees, $1,560,000 (0% financed with nongovernmental sources). This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.