2024/2025 ACDIS CDI Leadership Council Application

The ACDIS Leadership Council connects forward-thinking CDI leaders through insight-sharing and networking experiences.

Through their active participation in the community, Council members gain perspective on strategic priorities, special resources that reveal how their teams and processes stack up on important metrics, and exclusive invitations to leadership opportunities tailored to their interests and expertise.

We encourage all eligible CDI leaders to apply for the 2024/2025 term with this simple application form. Before applying, please review the complete Council details and guidelines on the ACDIS website to ensure you meet experience and participation requirements: https://acdis.org/acdis-leadership-council

Please note that Council membership is currently limited to CDI leaders employed by healthcare provider organizations.

Application deadline: August 31

Questions? Email ACDIS Associate Editorial Director Linnea Archibald at linnea.archibald@hcpro.com.

Question Title

* 1. Please enter your contact information in the fields below.

First Name *

Last Name *

Mailing Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone Number *

Question Title

* 2. Is the address you provided your personal mailing address or your work address?

Note that we may occasionally mail you Council-related materials.

Mailing address

Work address

Question Title

* 3. Is the email address you provided a personal or work email address?

Note that some organizations have firewalls in place which flag some Council emails and may prevent you from receiving all the notifications.

Personal email

Work email

Is there another email address we can reach you at if need? If yes, please provide it here.

Question Title

* 4. Please list the credentials you currently hold.

Question Title

* 5. Does your current position involve direct oversight of staffing, educational, strategic, and/or purchasing decisions for the department?

Yes

2024/2025 ACDIS CDI Leadership Council Application

Question Title

* 1. Please enter your contact information in the fields below.

Question Title

* 2. Is the address you provided your personal mailing address or your work address? *Note that we may occasionally mail you Council-related materials.*

Question Title

* 3. Is the email address you provided a personal or work email address? *Note that some organizations have firewalls in place which flag some Council emails and may prevent you from receiving all the notifications.*

Question Title

* 4. Please list the credentials you currently hold.

Question Title

* 5. Does your current position involve direct oversight of staffing, educational, strategic, and/or purchasing decisions for the department?

Question Title

* 6. Please indicate your title.

* 2. Is the address you provided your personal mailing address or your work address?

Note that we may occasionally mail you Council-related materials.

* 3. Is the email address you provided a personal or work email address?

Note that some organizations have firewalls in place which flag some Council emails and may prevent you from receiving all the notifications.