WVHIMA Professional Development AwardProfessional Development Award Name * Name Name Name Credentials Email * Phone AHIMA Examination applying to take * Registered Health Information Technician (RHIT) Registered Health Information Administrator (RHIA) Certified Coding Associate (CCA) Certified Coding Specialist (CCS) Certified Coding Specialist Physician Based (CCS-P) Certified Documentation Improvement Practitioner (CDIP) Certified Healthcare Data Analyst (CHDA) Certified in Healthcare Privacy and Security (CHPS) Certified Healthcare Technology Specialist (CHTS) Certified Professional in Health Informatics (CPHI) AHIMA Member ID # * AHIMA Membership State (for exam pricing) Professional Goals – 150 words or lessDescribe the professional goals you would like to achieve in two to four years. Include which credentialing examination you are applying and explain why you have chosen this credential or examination. Explain how this will help you meet your goals and further develop your professional career. * Accomplishments (Personal, Professional and Academic) – 100 - 200 wordsPlease describe your personal and/or professional accomplishments of which you are most proud. This can include organizational activities in which you have participated, leadership positions you have held in organizations, projects you have lead, academic and other awards received, etc. * WVHIMA Involvement – 100 - 200 wordsPlease describe your involvement in WVHIMA related activities or groups. This would include volunteering or service that is either formal or informal and/or is done in consultation with any health information management local group, affiliate, or other nonprofit, governmental, and community-based organizations as applicable to these organizations' goals. * LeadershipPlease describe your personal and/or professional leadership abilities demonstrate success with abilities. Include how this certification or examination will demonstrate additional leadership abilities and competencies as an HIM professional. * Final CommentsPlease add any final comments that would demonstrate you to be the recipient for the Professional Development Award that you would like the selection committee to be aware. If you are human, leave this field blank. SubmitΔ
