Arizona Healthcare Financial Management Association (AZHFMA)

Sponsorship Application /Renewal Form

Contact Name: *
Company Name: *
Address: *
City: *
State: *
Zip: *
Phone Number: *
Email Address: *

Business Services Offered: (Maximum of 3)
Accounting/Auditing Services Actuarial Services
Appraisal/Valuation Services Benchmarking Data Services
Capital Equipment Leasing Coding/Documentation/Chargemaster
Collection and A/R Recovery Services Compensation/Employee Benefits
Compliance/Fraud & Abuse Computer Hardware
Computer Software Consulting Services
Contract Management Services Debt Restructuring
Decision Support Systems/Services Document Management Products
EDI Products/Services Education Training
Electronic Health Records/Info Exchange Eligibility/Denials Management
EMR Implemetation/Optimization Executive Search Firms/Staffing
Facilities Design and Construction Financial Planning
Financial Services Group Purchasing Organizations
Healthcare Publications Home Care Products/Services
Housekeeping/Food Service Human Resources/Employee Benefits
ICD-10 Information Technology
Insurance Products/Services IT Infrastructure
Investment Banking Investment Products/Services
Managed Care Products/Services Materials Management
Mergers and Acquisitions Operations/Clinical/Performance Mgmt
Outsourcing Services Patient Account Mgmt/Business Office
Patient Record Products/Serices Physician Practice Acquisitions Services
Physician Practice Management Professional Member/Trade Organization
Property/Plant Equipment/Supplies Quality/Patient Safety
RAC Services Reimbursement Services
Retirement Planning Revenue Cycle
Risk Management Strategic Advisory/Capital Planning
Supply Chain Telecommunications Equipment/Services
Temporary Staffing Time and Attendance Systems
Treasury Services Used, New and Refurbished Equipment

Please Select Your Preferred Sponsorship Level: *
Platinum - $3,000
Gold - $2,000
Silver - $1,500
Bronze - $750