Distinguished Member Award Nomination FormNote: It is suggested that the group or individual nominating this candidate inform the nominee that they are proposing his/her name to guarantee that the information submitted is accurate.OrHIMA Distinguished Member Nomination Form About the NomineeNominee Name * Nominee Name Nominee Name Nominee Name Credentials Title Company Street Address City State Zip Nominee Email * Nominee Phone * About the SubmitterSubmitter Name * Submitter Name Submitter Name Submitter Name Credentials Title Company Street Address City State Zip Submitter Email * Submitter Phone * Narrative Summary A narrative summary that explains the nominee's qualifications for the award (please refer to OrHIMA's Nomination Criteria for eligibility requirements below) and why you think your nominee deserves state recognition.OrHIMA's Nomination CriteriaMust be member in good standing of AHIMA/OrHIMA.Must meet at least two of the following criteria:Fifteen years service as an active medical record practitionerAt least ten years service to the OrHIMA and/or the AHIMA, i.e. officer, director, committee chairman, project manager or member, delegate to the AHIMA Houses of DelegatesA contribution to the medical record professions in any of the following: Publication, Education, Systems Design, Public Relations, Research, etc. * If you are human, leave this field blank. SubmitΔMembersAnnual Business Meeting ReportsAwardsStudent Concierge ProgramUpdate Member ProfileVolunteer