MoHIMA The Professional Accomplishment and Engagement ProgramMoHIMA The Professional Accomplishment and Engagement Program Please complete the information below so that your request may be processed.No funds will be released unless all information is provided.Requests for reimbursement must be within 90 days from the date of passing the exam.Student Name * Student Name First First Last LastAddress * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Email * Phone * AHIMA ID * Name of CAHIIM College or University * Program Director Name * Program Director Name First First Last Last Program Director Email * Program Director Phone * Date of Graduation * Date you passed RHIT/RHIA exam * Additional Information Exam Results * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB If you are human, leave this field blank. SubmitΔ
