This form must be completed online. Faxed or mailed submissions will not be accepted.
Please note, contact Hour Approval is granted for two years, and will expire two years from the approval date.
Approval Request Information Original Approval Request: * Renewal Approval Request: * Previous IAHCSMM Approval Code:
Delivery Method Method of Delivery ( you may choose multiple methods):
Faculty (Please list each speaker, topic, objective and length of time. Clear objectives and time allocation for each topic must be submitted. A minimum of 1 speaker, topics, objective and length of time must be listed prior to submitting the request.)
(*) Contact Information - All fields are mandatory
Supporting Documents Submission Requirements: (1) Lectures and Conferences: also include a sample brochure and/or handout, clearly outlining the program title(s), objectives, and the number of contact hours planned for each topic; (2) Print and Online Publications: include a copy of the article or module including the post test, if applicable; and (3) Presentation and In-Services: include a copy of the handout, outline, or PowerPoint presentation (in PDF format) that will be used, including the post test, if applicable.
You may upload files directly from your desktop by following the steps below. We highly recommend that documents be either in PDF or Microsoft Word format, and total size capacity should not exceed 2 MB total.
We remind you that if your submission should have supporting documents, failure to upload them here may cause a delay in the approval process.