• Complement Change Request Form

  • Statement of Purpose

    The Neurohospitalist Society fellowship accreditation committee reviews and accredits neurohospitalist fellowship programs to ensure a standard level of educational quality and to promote training opportunities for neurohospitalists.

     

    Complement Change Request Form

    Use this form to request an increase in the total number of fellows your program is accredited to train annually. The fee for a complement change request when submitted separately from the annual status report or biennial program evaluation report is $500. 

     

    We recommend utilizing the "save" button at the bottom of the page as you fill out the form, if needed. A link will be emailed to you.

    For more information, please contact the Accreditation Committee at accreditation@neurohospitalistsociety.org. 

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  • Provide a sample schedule that illustrates how the fellowship plans to accommodate multiple learners. A sample schedule is provided here. Note, in this example both learners are never on the same rotation at the same time, but that does not preclude this option if a rotation can provide a robust learning experience for two fellows simultaneously.

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  • Please make your check payable to the Neurohospitalist Society and mail to:

    The Neurohospitalist Society
    Attn: Amanda Pacia
    1100 Melody Lane, Suite 2003
    Roseville, CA 95678

    *** Payment must be received by in order to process your application.

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    Complement Change Request Includes 3% credit card processing fee
    $ 515.00
       
    Total
    $ 0.00

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