Application for the Commission on Excellence and Innovation in Health CHIA Program 2021

Question Title

* 1. Applicant Information

Title

First Name

Surname

Work Email

Work Phone Number

Question Title

* 2. Job Role

Question Title

* 3. Employer

Question Title

* 4. Membership

Please indicate whether you are a member of any of the following:

AIDH - Australasian Institute of Digital Health (former HISA, ACHI)

HIMAA

None of the above

Other (please specify)

Question Title

* 5. Please confirm that your line manager is aware of your application and they understand the commitment required to take the exam (inside or outside of work) which may require between approximately 8-16 study hours per week over the 90 day period.

Yes, I confirm that my line manager is aware of my application and is aware of the commitment required to take the CHIA.

Other (please specify)

Question Title

* 6. Line Managers Contact Details

First Name

Surname

Title

Place of work

Organisation

Managers Work Email Address

Managers Work Phone Number

Question Title

* 7. Please confirm that you are happy for the CEIH to contact your line manager if further information is required in order to support your application.

Yes

Other (please specify)

Question Title

* 8. Eligibility Criteria
Associated health experience includes the following functional areas: healthcare and wellness, health administration/management, education, public health, health information management, health informatics, information and communication technology, information systems, healthcare and wellness research, data analytics, software architecture, cybersecurity, and project and program management.
Positions presented for associated health experience must have been held for a minimum of six months duration and within the last ten years.

Please, select the eligibility requirement which applies to you:

A degree plus six (6) continuous months of associated health experience*

No degree plus three (3) cumulative years of associated health experience*

Question Title

* 9. In no more than 200 words please outline your reason for wanting to take the CHIA certification.

Question Title

* 10. In no more than 200 words please outline how you becoming a CHIA would then benefit the South Australian health system in the future.

Question Title

* 11. Reimbursement

I confirm that if accepted into the CHIA certificate program, and funded by CEIH, I am expected to take the exam within the 90-day period after I have logged in or within an agreed extension timeframe given by CHIA inline with the 'Exam Extension' Policy. I acknowledge that if I do not take the exam without a legitimate reason and within the CHIA extension policy, then the CEIH reserves the right to seek reimbursement of the certification cost ($720) from me.

Thank you for completing this Expression of Interest. We aim to let all applicants know the outcome of their application by 15 April 2021.

Application for the Commission on Excellence and Innovation in Health CHIA Program 2021

Question Title

* 1. Applicant Information

Question Title

* 2. Job Role

Question Title

* 3. Employer

Question Title

* 4. MembershipPlease indicate whether you are a member of any of the following:

Question Title

* 5. Please confirm that your line manager is aware of your application and they understand the commitment required to take the exam (inside or outside of work) which may require between approximately 8-16 study hours per week over the 90 day period.

Question Title

* 6. Line Managers Contact Details

Question Title

* 7. Please confirm that you are happy for the CEIH to contact your line manager if further information is required in order to support your application.

Question Title

Question Title

* 9. In no more than 200 words please outline your reason for wanting to take the CHIA certification.

Question Title

* 10. In no more than 200 words please outline how you becoming a CHIA would then benefit the South Australian health system in the future.

Question Title

* 11. Reimbursement

* 4. Membership

Please indicate whether you are a member of any of the following: