Healthcare Council of Western Pennsylvania

100 Allegheny Drive, Suite 106
Warrendale, PA 15086
724-772-7206
hcwpadmin@hcwp.org

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Industry Member Application Test

For any questions regarding this application, please contact Chad Hilliard at chad.hilliard@hcwp.org or 878.217.1763.

Business Name

Email

Business Address

Address Line 1

Address Line 2

City

State

Zip

Country

Facility Representatives

Representative #1 (Primary)

First Name

Last Name

Text Input

Phone Number

Chief Executive Officer

First Name

Last Name

Text Input

Phone Number

Chief Financial Officer

First Name

Last Name

Text Input

Phone Number

Chief Operating Officer

First Name

Last Name

Text Input

Phone Number

Senior Nursing Leader

First Name

Last Name

Job Title

Text Input

Phone Number

Senior Human Resources Officer

First Name

Last Name

Job Title

Text Input

Phone Number

Organization Information

What was your Total Net Patient Revenue from your last audited financial statement? (This will help us determine what membership due tier to place you in)

Organizatin Type

Acute Hospital (Independent)

Acute Hospital (Health System)

Long Term Care

Intellectual and Development Disabilities

Behavioral Health/Drug & Alcohol

Other (Please Explain in Box Below)

What are you interested in through your membership with the Healthcare Council? (check all that apply)

Networking

Educational Webinars

Events and Workshops

Learning and Development

Committee and Task Force Engagement

New Business Partners (Vetted by Healthcare Council

Workforce Recruitment

Data Analytics

Other (Please Explain in Box Below)

How Did You Hear About Us?

Healthcare Council Member

Healthcare Council Board Member

Attended a Healthcare Council Event

At a Networking Event

Other (Please Explain in Box Below)

About Healthcare Council of Western Pennsylvania

We help Western Pennsylvania health care providers and organizations, realize their missions while maintaining their status as economically viable entities. Learn More…

News & Updates

Upcoming Healthcare Council Member Meetings & Events
Council Recognized as Partner in COVID Regional Response Program
Teen’s Guide to Medical Independence Website
Recruiting Program
Cyber Security Program

Contact Us

100 Allegheny Drive, Suite 106
Warrendale, PA 15086
724-772-7206
hcwpadmin@hcwp.org

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