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Certified Medical Staff Recruiter Application Form

Certified Medical Staff Recruiter Application Form

Application for CAMSR, CMSR, or CMMSR credentials.
  • Contact Information

  • Employment Information

  • Please upload a signed and dated letter, on company letterhead, specifying the date that you began your employment and that you are currently employed with that company. *Note: Employment does NOT have to be consecutive. If you have not been employed at your current place of employment long enough to meet the 2+ year CMSR, or the 5+ year CMMSR employment requirement, please submit one letter per company for which you were employed as a physician recruiter prior to your current position.
    Accepted file types: jpg, gif, png, pdf, doc.
  • Education

  • Please indicated which AAMM training course you completed within 12 months of submitting this application for CAMSR certification, or 36 months for CMSR and CMMSR certification.
  • Please upload a copy of your AAMM Certificate of Completion corresponding to the AAMM training that you specified above.
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  • Please indicate the date that you completed your CMSR examination
  • Professional Membership

  • Please upload a copy of your AAMM membership card
    Accepted file types: jpg, gif, png, pdf, doc.
  • Qualifying Accomplishments (for CMSR and CMMSR applicants only)

    In addition to the above criteria you must meet at least 14 units of professional accomplishment within three years of your application date to meet CMSR requirements. Qualifying accomplishments include: ​​​1 unit​ per 3 hours related continuing education (no limit) ​​1 unit per hour taught or page published in related field (up to 3 units) ​1 unit per year in related professional association (up to 2 units) ​1 unit per award or professional designation (up to 2 units) ​​1 unit per 1/4 year of full time employment in medical staff recruitment (up to 12 units) If you are applying for the CMMSR credential, you are required to demonstrate at least 24 units of professional accomplishment within three years of your application date. Qualifying accomplishments include: 1 unit​ per 3 hours related continuing education (no limit) 1 unit per hour taught in related field (up to 3 units) 1 unit per article published in related field (up to 10 units) ​1 unit per award or professional designation (up to 2 units) 1 unit per year in related professional association (up to 3 units)​ 1 unit per 1/4 year of employment in medical staff recruitment (up to 12 units)​​
  • Please upload verification of any continuing education that you have completed within 36 months of the date this form is submitted that you wish to be declared for Professional Accomplishment credit.
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  • Please upload verification of any courses taught, presentations, or lectures given that you have completed within 36 months of the date this form is submitted that you wish to be declared for Professional Accomplishment credit. Please make sure that your verification includes the number of hours taught.
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    Accepted file types: jpg, gif, png, pdf, doc.
  • Please upload verification of any articles that you have published within 36 months of the date this form is submitted, that you wish to be declared for Professional Accomplishment credit.
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    Accepted file types: jpg, gif, png, pdf, doc.
  • Please upload verification of any awards and/or professional designations, received within 36 months of the date this form is submitted, that you wish to be declared for Professional Accomplishment credit.
    Accepted file types: jpg, gif, png, pdf, doc.
  • Please upload verification of related professional associations that you have belonged to within 36 months of the date this form is submitted, that you wish to be declared for Professional Accomplishment credit. Please make sure that your verification includes the dates you were/are in good standing.
  • Please upload verification of related employment, within 36 months of the date this form is submitted, that you wish to be declared for Professional Accomplishment credit. Please make sure that your verification includes the dates you were/are employed.
  • Verify & Submit

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