1.Name (First & Last)

2.Email Address

3.FHIMA Regional Affiliation

Central Region (CFHIMA) - Brevard, Lake, Orange, Osceola, Seminole 

Gulfcoast Region (GCHIMA) - Citrus, Dixie, Hernando, Hillsborough, Levy, Marion, Pasco, Pinellas, Polk, Sumter

Northeast Region (NEFHIMA) - Alachua, Baker, Bradford, Clay, Columbia, Duval, Gilchrist, Hamilton, Lafayette, Nassau, St. Johns, Suwannee, Union 

Northwest Region (NWFHIMA) - Bay, Calhoun, Franklin, Gadsden, Gulf, Holmes, Jackson, Jefferson, Leon, Liberty, Madison, Taylor, Washington, Wakulla

South Florida Region (SFHIMA) - Broward, Miami-Dade, Monroe

Southwest Region (SWHIMA) - Charlotte, Collier, DeSoto, Hardee, Highlands, Lee, Manatee, Sarasota

Suncoast Region (SHIMA) - Glades, Hendry, Indian River, Martin, Okeechobee, Palm Beach, St. Lucie

4.Do you plan to attend the in-person FHIMA Hill Day on April 4th in Tallahassee?

Yes

No

5.I am interested in contributing to the FHIMA Advocacy efforts by:

Attending Hill Day in-person

Calling and emailing legislator offices to schedule appointments for the in-person attendees

Participating in the Twitter rally

Contacting my legislator and sharing FHIMA's issue paper and We Are FHIMA document