Association of Clinical Documentation Improvement Specialists (ACDIS) CDI Professional of the Year Award Nomination form Do you work with a colleague who has helped launch a successful clinical documentation improvement (CDI) program in your hospital? Do you know of a peer who has made outstanding contributions to the field of CDI? Nominate your CDI specialist peers for this annual award sponsored by the Association of Clinical Documentation Improvement Specialists (ACDIS). To do so, please fill out the following information and submit this form to ACDIS Director Brian Murphy (email@example.com). We will select one winner and two honorable mentions, and present them with an award at the ACDIS 2009 Annual Conference at Caesars Palace, Las Vegas, NV. The winner will receive one free admission to the conference. Nominee Information Name: Job Title: Organization: Email Phone number: Please explain in 150 words or less why this person should be considered for this award List of nominee’s accomplishments (list at least three) 1. 2. 3.