SHM Membership Ambassador

SHM Membership Ambassador

Refer your colleagues to SHM!
Your information
EmailAddress
MemberType
IsAMember
userName
FirstName
LastName
ct
Your SHM ID
(2-10 digits long. ex: 0001234567)
* all fields are required *
Your name*

First NameLast Name
Your email address*
example@example.com
Referred Colleague
Their role in Hospital Medicine*

PhysicianNP/PAAffiliateAllied HealthHospital Medicine Administrator
Their name*

First NameLast Name
Their email address*
example@example.com
Do you want to refer another colleague?*

YesNo
Their role in Hospital Medicine*

PhysicianNP/PAAffiliateAllied HealthHospital Medicine Administrator
Their name*

First NameLast Name
Their email address*
example@example.com
Do you want to refer another colleague?*

YesNo
Their role in Hospital Medicine*

PhysicianNP/PAAffiliateAllied HealthHospital Medicine Administrator
Their name*

First NameLast Name
Their email address*
example@example.com
Do you want to refer another colleague?*

YesNo
The 25/50/100% discount received by successfully referring new members cannot be combined with other discounts.

By submitting the form you are agreeing to the terms and conditions of the Membership Ambassador program.
Thank you, again, for your interest in SHM's Member Ambassadors. It appears that you are not currently an active member of SHM. Please check your My Account page to join, rejoin, or confirm your member status with SHM. If you believe that this is an error, you can call to member support at 800-843-3360 or email at customerservice@hospitalmedicine.org.
Should be Empty:

SHM Membership Ambassador

Your information

Referred Colleague