MaHIMA Volunteer Form

Are you human?
Leave this empty if you are a human. This is to prevent spam. Yes! I want to volunteer!

Name: Employer Prefered method of contact

Phone Number: Email Address:

I am interested in serving on the following committee/task:

Awards Committee

Coding Committee

Coding Roundtable Hosting

Communication Committee

MaHIMA Connect – writing an article

Education Program Planning

Legislative Affairs (Beacon Hill Day Planning, Education Planning, Medicolegal Guide Revision)

Public Relations Sub-committee

Please click submit above, or fax this form to MaHIMA’s Central Office at 978-649-2730, or mail to: MaHIMA, PO Box 681, Tyngsboro, MA 01879

Thank you for your time & commitment!!!