AASM Fellow Membership Application

To be considered for fellow membership, please complete this form and submit it, along with the required attachments to

Name: Click here to enter text. Member Number: Click here to enter text. / Office Use Only
Requirement 1: Be certified in sleep medicine by an American Board of Medical Specialties (ABMS) member board or an American Osteopathic Association (AOA) specialty certifying board OR certified in Behavioral Sleep Medicine by the ABSM. / ☐
Which board certified you in sleep medicine? (Check One)
ABMS Member Boards
☐ABIM / ☐ABOto
☐ABPN / ☐ABA (Anesthesiology)
☐ABP (Pediatrics) / ☐ABFM
AOA Specialty Certifying Board
☐Family Physicians / ☐Neurology and Psychiatry
☐Internal Medicine / ☐Ophthalmology and Otolaryngology
☐American Board of Sleep Medicine (in behavioral sleep medicine)
Requirement 2: Hold membership in the AASM Regular category for the last five consecutive years.
What year did you join the AASM? Click here to enter text. / ☐
Requirement 3: Demonstrate special contributions to scientific literature or significant advancements in the field of sleep medicine in at least two of the following three areas: Research, Service, or Education. / ☐
Research: Describe below contributions to scientific literature or significant advancements in the field of sleep medicine. Contributions should be referenced.
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Service: Describe below participation in the practice of sleep medicine with proven leadership within the community relating to the advancement of sleep medicine. This can include activities within the AASM or leadership at a local or regional level.
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Education: Describe below dedication to the advancement of the field of sleep medicine through teaching, which may include the development of courses, training of medical students, residents and fellows, or provision of continuing medical educations in sleep medicine.
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Required Attachments:

☐ Documentation of current certification by ABMS member board, AOA specialty certifying board, or ABSM (certified in Behavioral Sleep Medicine)

☐ Curriculum Vitae

☐ Letter of recommendation from someone board certified in sleep medicine by the ABSM, an ABMS member board, or AOA specialty certifying board describing the nominee’s achievements in at least two of the three above- noted areas

☐ Letter of support from an independent medical professional outside the group or department of the nominee

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