Fellow Candidate Submission Form

Name

Title

Professional Category

Select or enter value

Firm/Organization

City

State

Zip Code

Email

Phone Number

Year Joined AHLA

What do you consider to be your most important contribution to AHLA?

Please provide detailed and specific responses. The Fellows Coordinating Council reviews only the application, with all identifying information redacted, ensuring candidates are evaluated solely on the quality and depth of their answers.

Please summarize your activities of volunteer and leadership service at AHLA.

Please provide detailed and specific responses. The Fellows Coordinating Council reviews only the application, with all identifying information redacted, ensuring candidates are evaluated solely on the quality and depth of their answers.

Provide information you believe will be helpful to the Fellow’s Coordinating Council’s deliberations, e.g., service on other health law-related boards, committees, and associations.

Please provide detailed and specific responses. The Fellows Coordinating Council reviews only the application, with all identifying information redacted, ensuring candidates are evaluated solely on the quality and depth of their answers.

Describe your experience in implementing or supporting programs to increase inclusion, diversity, equity, and accessibility (IDEA) both within and outside the Association and how you advance IDEA at AHLA.

Please provide detailed and specific responses. The Fellows Coordinating Council reviews only the application, with all identifying information redacted, ensuring candidates are evaluated solely on the quality and depth of their answers.

What would becoming an AHLA Fellow mean to you?

Please provide detailed and specific responses. The Fellows Coordinating Council reviews only the application, with all identifying information redacted, ensuring candidates are evaluated solely on the quality and depth of their answers.

I confirm I am a current AHLA member, have belonged to AHLA 15+ years, and have actively practiced health law or in a health-related profession for 15+ years.

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