Thank you for applying to serve on an ACDIS board or committee! Please note that after you complete question 6, you will be directed to another page with the application for the particular committee for which you're applying. Please fill out all requested fields in order to be considered for committee service.

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* 1. Please provide your name, credentials, and contact information.

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* 2. Please indicate whether you work as a consultant or in the provider/hospital setting.

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* 3. How long have you been in the CDI profession?

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* 4. Are you an ACDIS member? (Please note, all ACDIS committee members must be ACDIS members.)

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* 5. Please upload your headshot and professional bio (in one file, please).

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