State Chapter Volunteer Form
Join the State MGMA volunteer community and be a catalyst for positive change in healthcare. The following State Chapters need volunteers: AL, AZ/NM, FL, IA, MD, MA/RI, MI, MN, NE, NV, NH/VT, NJ, OH, TX, VA, WA, WI.
Name
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First Name
Last Name
Credentials
Email
*
example@example.com
Title
*
Company
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Phone Number
Please enter a valid phone number.
City, State (Ex. Denver, CO)
*
Which volunteer position are you interested in?
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Board of Directors
Membership Committee
Education and Events Committee
Legislative Liaison
ACMPE Forum Representative
Are you willing to volunteer 25-100 hours annually for your State Chapter?
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Yes/No
Have you served as a volunteer for a State MGMA or National MGMA before? If yes, please provide a description.
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Please provide a description of your skill set, knowledge and experience in the field of Medical Practice Management.
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Submit
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