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Application for NHIA Committee Participation

NHIA's volunteer committees are the driving force behind all association policies, projects, and activities. These committees are ongoing working groups that meet monthly via conference call. We are seeking dedicated, experienced, home infusion professionals who can allocate a few hours a month to actively work to identify and address issues of concern to our community. Qualifications/experiences guidelines for committee applicants include at least five years experience in home infusion and that you have been an active NHIA member for at least two years. Read more information about what's involved with being on an NHIA committee.

Interested individuals should fill out the following application.
Candidates will be considered based on qualifications, and willingness and ability to work on committee activities. Successful candidates will be contacted by their committee chair to begin serving in the upcoming committee cycle.

Contact Information

Member Number
Name
Title
Company
Address
City
State
Zip
Phone
Fax
E-mail
Year you joined NHIA (approx).

Discipline/Specialty

 Pharmacist  Information Systems
 Nurse  Physician
 Owner/Management  Operations
 Reimbursement Manager  Finance
 Consultant  Other (please specify)

Practice Setting

Home IV pharmacy Manufacturer/distributor/other supplier
Physician office Consulting
Home health agency Other (please specify)
Outpatient infusion clinic  

Committee/Activity of Interest

Education Home Infusion EDI Coalition
Payer Relations Legislative
Membership Standards/Accreditation

Please briefly describe why you would like to serve on a committee and what issues you are particularly interested in working on.
Please give a brief bio of your professional experience.
Are you planning to attend the next NHIA Annual Conference? Yes   No