AAHS Mentor Application - American Alliance for Healthy Sleep
Thank you for your interest in participating in the AAHS Patient Mentor Program. Please review the AAHS Patient Mentor Program Guide and complete the Participation Agreement prior to submission of your application.

The following information is needed to both ensure you qualify to participate in the AAHS Patient Mentor Program, as well as provide information that may be important for mentors/mentees to make decisions regarding mentorship relationships that best fit their needs.

Please provide the requested information; the AAHS will contact you regarding your participation in this program after this form has been submitted.

If you are filling out this form for the first time, please click the New Submission button on the left .

If you are returning to edit or complete a previous submission, please fill out the email address and access code you set up previously and click Edit Submission.

First time submission

Edit existing submission
(fill out email address and access code to edit form)