Application Information

Please complete this application to be considered for the following roles:
  • Health Policy Education Subcommittee Co-Chair
  • Health Policy Clinical Practice Subcommittee Co-Chair
  • Health Policy Research Subcommittee Co-Chair
  • Associate Member: Health Policy Executive Committee
  • LEAHP Associate Program Director
If you have any questions, feel free to reach out to the HPC Chair, Dr. Michael Fischer (michael.fischer@bmc.org), or Francine Jetton, SGIM Senior Director of Communications (jettonf@sgim.org).

The deadline to submit an application is 11:59 PM ET, December 5, 2025.

You must be a member to be considered for any SGIM Committee or Subcommittee chair role.

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* 1. First Name

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* 2. Last Name

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* 3. What is Your Institution?

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* 4. Please Tell Us Your Preferred E-mail Address.

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* 5. I affirm that I am a current member of SGIM.
You must be a member to be considered for any SGIM Committee or chairperson role.

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* 6. What Is Your Current Academic Rank?

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* 7. Is This Your First Time Volunteering with SGIM?

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* 8. For which position will you be applying?

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