H.I.M. Contact Update Form

Help keep your contact information current with the Health Information Management Department by completing the following information. All fields are optional. Please note: this form is only for records used by the H.I.M. program and does not affect information in other departments. Other organizations, such as KU Alumni Office and KU Endowment keep independent information and these must be updated separately upon request.

First Name		Last Name
HIM graduating year
Home Email Address		Work Email Address
Home Telephone Number:		Work Telephone Number:
Home Mailing Address		Work Mailing Address
Job/Position Title		Organization/Employer

Comments, questions or news to share with other Alumni: Please note: This form is only for the KU Health Information Management program. Alumni of other programs in the KU School of Allied Health should update their information by contacting the KUMC Alumni Office or their Academic Department.