Annual Status Report

Annual Status Report
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.

Annual Status Report
An annual status report must be submitted by May 1 during years when the biennial program evaluation report is not due. Use the form below and upload the required documents.

ANNUAL RENEWAL FEE: $2000

Please review the institutional and core program requirements before submitting your annual status report.
Institutional requirements
Core program requirements

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

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

First Name Last Name Degree(s)
Email:
example@example.com
Institution:
Institutional Requirements
Sponsoring Institution: Neurohospitalist fellowships must be overseen by a Sponsoring Institution that maintains institutional accreditation with the Accreditation Council for Graduate Medical Education (ACGME) or the Canadian Excellence in Residency Accreditation (CanERA). Programs seeking accreditation must provide a letter, signed by the Designated Institutional Official or representative, stating the Sponsoring Institution’s ACGME or CanERA accreditation is current, and that the Graduate Medical Education Committee (GMEC) or Postgraduate Education Committee has knowledge of the Neurohospitalist fellowship and has approved its application for accreditation as relevant to the Sponsoring Institution.
Name of sponsoring institution:
Sponsoring Department: The sponsoring institution must have a department that takes primary responsibility for the neurohospitalist fellowship. The fellowship director must be a member of this department.
Department that takes primary responsibility for the neurohospitalist fellowship:
Is the neurohospitalist fellowship director a member of this department?

Yes No
Stop. The neurohospitalist fellowship director must be a member of the department taking primary responsibility for the fellowship.

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Expiration Month	Expiration Year
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Annual Status Report

Institutional Requirements

Core Program Requirements

Fellows

Major Changes