American Association of Managed Care Nurses

“Educating Nurses in All Aspects of Managed Care”
   

 

AAMCN Leadership Institute Mentor Program
Mentee Information Form

"Mentor:  Someone whose hindsight can become your foresight"
 


  1. Please fill out the below information and apply to be a part of our Mentoring Program.
Name:
Position/Title:
Address:
City:
State:
Zip:
Phone Number:
E-Mail Address:
Best Way to Contact You:
Best Time to Contact You
(Please include the time zone):

  1. Please indicate the area(s) in which you are looking to receive Mentoring:
Leadership
Fundamentals of Managed Care
Utilization Management
Disease Management
Appeal Management
Medicare/Medicaid Managed Care
Administration/Management
Patient Education
Technology/Internet
Reporting
Research
Quality Improvement/Performance Improvement
Case Management
Other:
If there is a particular mentor that you would prefer to receive coaching from, please specify:
   
 

Help us cut down spam.

Type the number 411 into
the following box (Required)