KHIMA MVP Nomination Form

2020 KHIMA MVP Award

The MVP Award is activity based and intended to honor a professional who has played a large role in recent projects within the HIM profession.

Nominee Information

Name *

First

Last Name *

Last

AHIMA ID *

Phone Number *

Work Address *

Street Address

City *

State *

Zip Code *

Number of years in the HIM profession *

File Upload

Maximum upload size: 134.22MB

Nominator Information

Name *

First

Last Name *

Last

AHIMA ID *

Email Address *

Phone Number *

Address *

Street Address

City *

State *

ZIP Code *

Reason for Nomination

Please explain why you have selected this nominee. *

Project Information

Project *

Role *

Signature

Nominator's Signature *

Date *

Application Deadline is June 1st, 2020.

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