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  • Clinical Resources
    • Practice Standards
      • Practice Guidelines
      • Endorsed Guidelines
      • Guideline Development Process
      • Guidelines in Development
      • Consensus Statements and Papers
      • Quality Measures
      • Volunteer
    • Coding and Reimbursement
      • AMA CPT and RUC
      • CMS Physician Fee Schedule
      • Coding FAQ
      • E/M Code Changes
      • Medicaid Resources
      • Medicare Policies
      • Medicare Audit Toolkit
      • MIPS
      • Payer Advocacy
      • Payer Policy Scorecards
      • Sleep Medicine Codes
      • Telemedicine Codes
    • Col 3
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      • ICSD
      • Artificial Intelligence
      • COVID-19 Resources
      • EHR Integration
      • Emerging Technology
      • Journals
      • Patient Information
      • Practice Promotion Resources
      • Provider Fact Sheets
      • #SleepTechnology
      • Telemedicine
    • Sleep Clinical Data Registry
      • The AASM Sleep Clinical Data Registry (Sleep CDR) is the first registry dedicated solely to sleep medicine to streamline data collection for quality improvement efforts, reporting, and benchmarking.
  • Professional Development
    • Choose Sleep
      • Paths to Sleep Medicine
      • Sleep Profession Profiles
      • Free Student/Resident Membership
      • Sleep Medicine Elective Toolkit
      • Sleep Medicine Resources
      • Sleep Medicine Webinars
      • AIRE Pilot Programs
      • Sleep Physician Training
    • Mentor/Sleep Team Training
      AASM Mentor Program
      Sleep Team Training
      • Advanced Practice Registered Nurses and Physician Assistants (APRN PA)
      • Accredited Sleep Technologist Education Program (A-STEP)
      • Inter-scorer Reliability (ISR)
      • Coding Education Program (A-CEP)
    • Col 3
      • Annual Meeting
      • Career Center
      • Case Study of the Month
      • Change Agents Submission Winners
      • Compensation Survey
      • Conference Support
      • Continuing Medical Education (CME)
      • Maintenance of Certification (MOC)
      • State Sleep Societies
      • Talking Sleep Podcast
      • Young Investigators Research Forum (YIRF)
    • Events
      Sleep press release
      Learn new ideas and best practices for professional growth. View descriptions and register for our upcoming live courses!
  • Membership
    • Individual/Facility Membership
      Individual Membership
      • Benefits
      • Categories
      • Members-Only Resources
      • Become an AASM Fellow
      • FAQs
      Facility Membership
      • Benefits
      • FAQs
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      • Donate
      • AASM Political Action Committee
      • Position Statements
      • Advocacy Toolkit
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      • Initiatives
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      • Specialty Practice
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      • Products and Services
      • Pursuing Advanced Sleep Practices
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      • Program Changes
    • Apply or Renew

      AASM accreditation demonstrates a sleep medicine provider’s commitment to high quality, patient-centered care through adherence to these standards.

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sample-gravity-form2023-08-18T10:02:23-05:00

2024/2025 Board of Directors and Nominating Committee Interest Form and Questionnaire

Submissions due November 17, 2023 at 11:59 pm

Submit this form and all required attachments by November 17th, 2023. Please review the AASM Conflict of Interest Policy before volunteering. Only voting members may serve on the AASM Board of Directors.

Nominee To-Do List:
  1. Login to your AASM member profile. Make sure your affiliations, contact information and diversity, equity and inclusion data are up to date and complete.
  2. Upload the following documents:
    1. CV, Resume, or Biographical Sketch

Section 1: Background Information

Name(Required)
Primary Specialty(Required)

Practice Type(Required)

Patient Mix: Please note what percentage of your patients are adult vs. pediatric

Please enter a number from 0 to 100.
Please enter a number from 0 to 100.

Sleep Disorders Mix: What estimated percentage of your work involves treatment of the following sleep disorders:

Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.

Payer Mix: Please note your estimated payer mix (if known):

Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.
Please enter a number from 0 to 100.

Are you Board Certified in Sleep Medicine?(Required)

AASM Leadership Experience

Are you an AASM Fellow?(Required)
Have you ever served as Chair of an AASM committee/task force/panel/course?(Required)

State Medical Licensing Board Disclosures

Have any disciplinary actions been threatened, initiated or are any pending against you by a state licensure board?(Required)
Has your license to practice in any state ever been denied, limited, suspended or revoked, diminished, not renewed, relinquished (whether voluntarily or involuntarily) or are any proceedings currently pending which may result in such action?(Required)

Required Attachments

Max. file size: 128 MB.

Section 2: Questions for Prospective Board Members / Nominating Committee Members

To assist the Nominating Committee and Board of Directors in their effort to identify applicants who will provide the best fit for the AASM and the needs of the Board and Nominating Committee in the years to come, please answer each of the following questions. Suggested word length for each question is 100-250 words. We ask that you do not exceed 300 words in any of your responses. Please write one sentence to a few paragraphs in response to each of the following questions, to assist the Nominating Committee and Board of Directors in their effort to identify applicants who will provide the best fit for the AASM and the needs of the Board and Nominating Committee in the years to come.
Which position(s) are you applying for:(Required)

Section 3: Leadership Profile

Please review the nine board leadership competencies (below). Choose three that you feel represent your greatest strengths. Comment on how you feel these qualities would positively impact your ability to fulfill a leadership role on the board. Please limit your responses to 200 words or less for each of the 3 chosen strengths.

1. Knowledge of the Organization

Having and using knowledge of systems, situations, pressures, and culture inside the organization to identify potential organizational problems and opportunities; perceiving the impact of decisions on other components of the organization through

  • understanding and using organizational policies and systems to solve problems
  • anticipating impact of actions on other groups

2. Developing, Communicating, and Sustaining a Vision

Creating and achieving a desired future state (vision) through influence on organizational values, individual and group goals, reinforcements, and systems by

  • defining a desired future state
  • communicating direction with enthusiasm
  • gaining commitment to vision and values

3. Integrity /Responsibility/ Accountability

Maintaining and promoting social, ethical, and organizational norms in conducting internal and external business activities by

  • sharing complete and accurate information
  • maintaining confidentiality
  • adhering to policies and regulations
  • meeting personal commitments and promises
  • setting high performance standards

4. Negotiation

Effectively exploring alternatives and positions to reach outcomes that gain all parties' support and acceptance by

  • exploring others' needs, concerns, and positions
  • keeping discussions issue oriented
  • seeking win-win solutions

5. Communication

Expressing ideas effectively in individual and group situations (including nonverbal communication); adjusting language or terminology to the characteristics and needs of the audience through

  • expressing thoughts clearly
  • soliciting ideas, suggestions and opinions from others
  • listening to all points of view with an open mind

6. Teamwork/Collaboration

Working effectively with team or work groups or those outside formal lines of authority to accomplish organizational goals; taking actions that respect the needs and contributions of others; contributing to and accepting the consensus by

  • exchanging information freely
  • supporting group decisions
  • putting group goals ahead of individual goals

7. Leadership/Motivating Others

Using appropriate interpersonal styles and methods to inspire and guide individuals toward goal achievement; modifying behavior to accommodate tasks, situations, and individuals involved through

  • focusing on the situation, not the person
  • asking for and gaining commitment to action
  • mutually agreeing on accomplishments

8. Innovation

Generating creative solutions to work situations; trying different and novel ways to deal with organizational issues and opportunities by

  • approaching job with imagination and originality
  • generating novel solutions
  • suggesting new ways to apply existing knowledge

9. Judgement/Problem Solving

Committing to an action after developing alternative courses of action that are based on logical assumptions and factual information; taking into consideration resources, constraints, and organizational value in all decisions by

  • considering alternatives
  • considering all pertinent facts
  • weighing pros and cons or impact of alternatives

Section 4: Technical Skills Assessment

For each skill listed below, please select the level you feel most appropriately represents your knowledge, expertise, and experience in the particular skill. If you have no experience or knowledge of a skill, please select “None".

Skills:

Technology Innovation(Required)
Artificial Intelligence(Required)
Telemedicine(Required)
Social Media(Required)
Value-Based Medicine(Required)
Advocacy / Government Relations(Required)
Coding / Compliance(Required)
Payor and Reimbursement Policies(Required)
Graduate Medical Education(Required)
Advanced Practice Provider Training(Required)
Scientific Research(Required)
Clinical Guideline Development(Required)
Quality Measures (eg MIPS)(Required)
Patient Advocacy / Engagement(Required)
Accreditation Process and Policies(Required)
Business Acumen(Required)
Financial Management(Required)
Legal Competency / Risk Analysis(Required)
HR Policies and Benefits(Required)
Compensation / Succession Planning(Required)
Application of DEI Knowledge(Required)
Strategic Planning(Required)
Certification Exam Development(Required)
Fundraising / Development Activities(Required)
Mentoring / Training / Teaching(Required)
Community Outreach(Required)
Public Health(Required)
Quality Improvement(Required)

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