MSHIMA Mentorship Connection Program Application Survey Question Title * 1. What is your interest in the MSHIMA Mentorship Program? I want to be a Mentor I want to be a Mentee I am interested in both Question Title * 2. Full name Question Title * 3. Credentials Question Title * 4. Employer/organization Question Title * 5. Job title Question Title * 6. Student status Student Professional Question Title * 7. City Question Title * 8. State Question Title * 9. Email Question Title * 10. Phone Question Title * 11. LinkedIn profile (optional) Question Title * 12. Years of HIM experience Question Title * 13. Areas of expertise (Select all that apply) Coding CDI Compliance Privacy Revenue Cycle Informatics Leadership Education Consulting Data Analytics Health IT Other Question Title * 14. Areas willing to mentor in (Select all that apply) Coding CDI Compliance Privacy Revenue Cycle Informatics Leadership Education Consulting Data Analytics Health IT Other Question Title * 15. Preferred mentee type Student Early Career Professional Mid-Career Professional Question Title * 16. Preferred communication method Email Phone Video Call Question Title * 17. Preferred meeting frequency Weekly Bi-Weekly Monthly Quarterly Question Title * 18. Time commitment available each month (in hours) Question Title * 19. Areas where mentorship is desired (Select all that apply) Career Development Skill Enhancement Networking Professional Growth Question Title * 20. Agreement (Select all that apply) I understand participation does not guarantee a match I agree to professional communication I understand my information will only be used for mentorship matching Done