2026 Interim HOD Committee Volunteer Form

This form is to be completed by volunteers for reference committees (other than F), the Rules & Credentials Committee, and tellers for I-26. Please indicate all positions which you would be interested in serving. You may make multiple individual selections or choose “ANY” if you are open to serving where needed.

Preference will be given to those who have not recently served; however, all interested are encouraged to apply. Those who currently serve on AMA councils will not be considered for service to allow for leadership opportunities for others.

Reference committees will meet virtually sometime between Friday, Oct 23 and and Thursday, Oct 29 2026, to develop their Preliminary Reference Committee Reports based on testimony received online. We ask that all who are interested in serving on reference committees hold that week open to accommodate these meetings.

As a reminder the November 2026 Interim meeting will be held Friday, November 6 - Tuesday, November 10, 2026.

Are you available to meet sometime between Friday, Oct 23 and Thursday, Oct 29, 2026, if selected to serve on a reference committee?

Are you able to attend the entire meeting (Nov 6 - 10) in order to participate in the presentation of the committee's final report before an HOD business session, if selected to serve on a reference committee?

Would you like to volunteer to serve as Chair of a reference committee?

Name

First NameLast Name

Email

example@example.com

State

Mobile Number

Area CodePhone Number

Specialty

Please select one

Name of the society or section you represent in the House of Delegates

Are you currently serving on an AMA Council?

Which AMA Council are you serving on?

PLEASE SELECT WHICH HOD COMMITTEE(S) YOU WOULD LIKE TO SERVE ON:

Reference Committee B - Legislative Advocacy issues; Reference Committee C - Advocacy related to Medical Education; Reference Committee on Ethics and Bylaws; Reference Committee J - Advocacy related to Medical Service, Medical Practice, Insurance and related topics; Reference Committee K - Advocacy related to Science, Public Health and related topics

Previous AMA HOD Committee Service

Please list only AMA HOD COMMITTEE EXPERIENCE (reference committee, task force, chaired a committee, etc)

Statement of Interest

Not to exceed 150 words.

Headshot for Pictorial Directory (optional)

Browse Files

Upload a headshot (.png, .jpg, or .jpeg) which will be added to the AMA's Pictorial Directory

If you have questions or require additional information please contact Patti Wargo, Office of House of Delegates Affairs at patti.wargo@ama-assn.org or 312-464-4463.

2026 INTERIM HOD COMMITTEE VOLUNTEER FORM