Wufoo
OSMA Leadership Application
To apply, please submit this form:
What position are you applying for?
OSMA At-Large Councilor
Ohio Delegate to the American Medical Association
Alternate Delegate to the American Medical Association
Name
*
First
Last
Cell Phone
*
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Email
*
Number of years as OSMA member
*
Your Leadership Competencies
(Check all that apply.)
*
health plan administration
governmental affairs
electronic communication (social media and patient engagement)
technology usage in clinical practice
diversity
managed care
alternative payment models (pay for quality)
fundraising
project management
public health
population health management
performance measurement
physician-hospital integration/alignment
physician practice management
public speaking
relationship building, peer to peer communication
leadership experience outside of organized medicine
leadership experience in the medical community
Your Personal Statement
*
Maximum of
3000
characters.
Currently Used:
0
characters.
Please submit below: (or email to smccullough@osma.org)
1) Headshot photo
2) Current CV (3 pages max)
3) and a letter of recommendation...*(required only if you are applying for an At-Large Councilor position OR if you are a NEW candidate running for the Ohio Delegation to the American Medical Association.)
I'll send via email to smccullough@osma.org
These files are uploaded here
Upload your photo...
Upload your CV...
Upload your letter of recommendation...
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