ASH Practice Partnership Nomination Form
The goal of the ASH Practice Partnership (APP) is to promote the expertise and represent the interests of practicing hematologists. The APP is comprised of a group of hematologists from community-based practices across the nation. APP members receive a variety of benefits and resources, including special opportunities to network with colleagues and to interact more fully with ASH and help shape ASH policies and programs. It also allows ASH to engage a broad network of practitioners to ensure that the Society practice-related programs and initiatives meet the needs of its members.

ASH would like your help identifying candidates to participate. We are asking that you nominate practices that meet the following criteria:

- Members will need to be board-certified in hematology and active members of ASH.
- Ideal candidates will be interested in both malignant and non-malignant hematology care issues, improving quality of care, engaging in new health care delivery systems, and practice management issues.
- There will be a membership emphasis on participation from private practices in the community.

If you would like to nominate multiple practices, please click the "Submit" button below and then select "Submit another response" on the confirmation page.

For questions or concerns, please contact Katherine Stark at or 202-292-0252

Nominator Name *
Your answer
Nominee Name *
Your answer
Nominee Email
Your answer
Practice or Institution *
Your answer
Practice City *
Your answer
Practice State *
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