Contact Us Interested in learning more about AIM? Fill out the form below to see how you and your hospital can get involved. Name* First Last Suffix Ex. John Smith, MD Organization*Ex. Memorial Hospital Role or title within organization*Ex. Resident Director Email* Please be sure to enter a valid email address. Supplemental materials will be sent to the address on fileState*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDelawareGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingNot in United StatesSelect 'Not in United States' if not in the United StatesHow would you like to collaborate with AIM?* This iframe contains the logic required to handle Ajax powered Gravity Forms.