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SEP HS17 ZHS1 (02)

Site

Teleconference

Notes

Affirma Solutions, Inc. is the new logistical contractor for AHRQ. Follow these steps to submit your honorarium form for processing:

  • Download the expense reimbursement form below, which is an Excel spreadsheet that has been pre-populated with your honorarium fee for this meeting.
  • A W9 form is also required to complete the process. You can also download this below.
  • Fill out all the forms, sign, date, and mail to: 

Affirma Solutions, Inc.
340 E. 2nd Street, Suite 409
Los Angeles, CA 90012
Attention: Syreeta Jones

A check will be mailed to you once Affirma has received the necessary information.

Forms

Expense Reimbursement

W-9

Earlier Event: October 26
HEOR Meeting
Later Event: October 27
HITR Meeting