AMA Code of Conduct Issue Reporting Form

We encourage all members of the AMA community to speak up when they see behavior that is not in keeping with the AMA Code of Conduct. Only through addressing these issues can we continue to make the AMA a safe place for all.

You can view the AMA Code of Conduct Reporting Procedures for more details on the process for reviewing conduct issues.

Today's Date(Required)

Your Name(Required)

Your Email(Required)

Your Phone(Required)

Your Role in the AMA Community(Required)

(e.g. member, chapter president, conference attendee, etc.)

Name(s) of Person(s) Who Allegedly Violated the AMA Code of Conduct(Required)

Please Describe the Issue(Required)

Please Describe What Section(s) of the AMA Code of Conduct You Believe Were Violated(Required)

Name and Contact Information for Other Witnesses (If Applicable)

OPTIONAL: Issue Routing

All issues are sent directly to the AMA Chief Executive Officer as Grievance Coordinator of the AMA. If for any reason you are not comfortable contacting the AMA CEO, choose the AMA Board Chair option below, and it will be routed to the Chair of the AMA Board of Directors.

Send this form to the AMA CEO

Send this form to AMA Board Chair