ACDIS January call for volunteers—boards and committees

Thank you for applying to serve on an ACDIS board or committee!

Please note that the ACDIS Advisory Board is not open to vendors or consultants as ACDIS tries to ensure unbiased and transparent guidance and thought leadership.

Question Title

* 1. Please provide your name, credentials, and contact information.

First and Last Name *

Credentials *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Company/Organization *

Email Address *

Phone Number *

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* 2. Please indicate whether you work as a consultant or in the provider/hospital setting.

Provider/hospital setting

Consultant

Other (please specify)

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* 3. How long have you been in the CDI profession?

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* 4. Please upload your headshot and professional bio (in one file, please).

PDF, DOCX, DOC file types only.

Choose File

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* 5. Are you an ACDIS member? (Please note, all ACDIS committee members must be ACDIS members.)

Yes

I don't know