Central Pennsylvania Health Information Management Association (CPHIMA)

CPHIMA_Logo_LABELED

CPHIMA is committed to the quality of health information for the benefit of patients, providers, and other users of clinical data.

CPHIMA Distinguished Member Nomination Form

CPHIMA Distinguished Member Nomination Form

About the Submitter

Submitter Name
Submitter Name
First Name
Last Name

About the Nominee

Nominee Name
Nominee Name
First Name
Last Name

Employment

Present Employment Status

Association Involvement

Instructions: Identify the association by name and list most recent activity first, including dates in each category.

Contributions to HIM

Maximum upload size: 268.44MB