THIMA Speaker Information Form Speaker InformationName * Name Name Name Credentials Company/Facility Name * Street Address * City * State * Zip * Phone Number * Email Address * Twitter Handle Title of Presentation * Provide 2-3 sentences explaining the learning objectives and content of your presentation and what the attendees will learn. This information will be included in the meeting brochure. THIMA reserves the right to edit this information. * Upload your CV / resume * Drop a file here or click to upload Choose FileMaximum file size: 268.44MB Provide a brief bio; this will be used for speaker introduction. * Provide a headshot; this will be used in the meeting program. Drop a file here or click to upload Choose FileMaximum file size: 268.44MBPlease respond to the following.As a subject matter expert in this this professional domain, I will present materials based on current information utilizing instructional methods appropriate for adults to meet the learning objectives of this topic. * Agree Disagree Comments I agree that this presentation may be recorded and accessible to THIMA members and other subscribers after the date of the presentation. * Agree DisagreeAs a speaker, I will disclose conflicts of interest or where none exist and include a slide within the presentation noting any conflicts of interest. * Agree DisagreeTHIMA is committed to eliminating commercial bias from all presentations. This directive is in keeping with AHIMA/THIMA’s dedication to quality, consistency, and rigor in education programming. Through your attestation, you are committing to the development and presentation of content free of commercial bias. * Agree Disagree Additional Comments Submit If you are human, leave this field blank. Δ
