MHIMA | Missouri Health Information Management Association

Last Name:
First Name:
Credentials:
AHIMA ID:
Address:
City, State, Zip:
Phone Number:
Email Address:
Candidate For:

The information below will be on the voting ballot.

Employment

Current Employer:
Current Position:

Previous Positions

Provide job position, organization, city/state, and dates of employment in reverse chronological sequence of positions held the last 10 years.

Education

Show degrees earned, dates, names of college or university.

HIM Association Activities

List all offices held or committee/project activities at the national, state or local HIM association(s).

Other Qualifications / Training / Experience

List any additional information that would be of value or assist in supporting your candidacy for an officer, delegate, or AHIMA Nominating Committee.

Position Statement

Please respond to the following:

There is a growing need for the HIM professional in the rapid technology movement of the EHR. We contribute valuable information related to the management of data. What is your strategy in promoting the education of HIM professionals overall, and particularly in the EHR movement and other advancing technologies?

Consent

We must have your consent to serve before we can enter your name and credentials into consideration as a nominee. Completion and receipt of this form signifies your consent to serve.

Thank you for agreeing to run on the MHIMA ballot.