Association for Healthcare Accreditation Professionals
Join us on the podium at the:
7th Annual Association for Healthcare Accreditation Professionals Conference
on June 6-7, 2013, in Las Vegas, NV


AHAP Conference Speaker Application
Please complete all of the fields below.

First Name
Last Name
Credentials
Title
E-mail Address
Phone#
Organization
Address
Address 2
City
State
Zip Code
Please describe your suggested 2013 AHAP session topic. If you are writing to recommend a colleague or peer as a presenter, please explain why you think this person would be a great addition to the podium.
Please explain why you are qualified to speak on your proposed topic.
Please summarize your background/qualifications in the field of clinical documentation improvement.
Please list any previous speaking or presentation experience.
Please specify whether your topic is intended for a basic, intermediate, or advanced audience.
Please provide two references and e-mail addresses that members of the 2013 AHAP Conference Committee can contact.

* All Fields Required


If faxing this form, please address the cover page to Jaclyn Zagami's attention.

Association for Healthcare Accreditation Professionals
AHAP: The Association for Healthcare Accreditation Professionals
Phone: 781/639-3348 / Fax: 781/639-7857