Skip survey header

MHIMA Program Director Verification

1. About the Student
2. About the Program Director
This question requires a valid email address.
3. About the School
4. Using the following scale, provide your recommendation rating:
5. Please upload a brief letter of reference that includes the student's potential for professional leadership.
6. I certify that the applicant listed above is in good standing and presently enrolled in the Health Information Program with plans to complete degree program.
Electronic Signature
Signature of