Montana Health Workforce Services aka WIM Tracking provides health care practices, state leaders, educational coordinators and researchers with data services regarding the distribution of Wyoming, Idaho and Montana’s health workforce. WIM is the contractor for the Montana Primary Care Office a division of Montana DPHHS tasked with the collection and maintenance of workforce data use to manage Montana’s dental and mental health professions shortage areas (HPSAs).  Thank you for your help in completing this brief form and returning it to WIM. An electronic version is available at wimtracking.org/submit.

Key 1 – ADHD   2 – Addiction   3 – Anorexia Nervosa   4 – Autism Spectrum Disorder   5 – Celiac Disease   6 – Cerebral Palsy   7 – Cystic Fibrosis   8 – Down Syndrome   9 – Epilepsy   10 – Fetal Alcohol Syndrome   11 – Fragile X Syndrome   12 – Hydrocephalus   13 – Muscular Dystrophy   14 – Multiple Sclerosis   15 – Obesity   16 – Paralysis   17 – Skeletal Dysplasia   18 – Spina Bifida   19 – Tourette Syndrome   20 – Other

Please return completed form to: WIM Tracking PO Box 302 Townsend, MT 59644 or [email protected]. Direct questions to Jena Smith (406) 640-1230 or [email protected].