Submit a request – American Medical Association

Please select your request type. Once submitted, a ticket confirmation screen will provide a summary of the information you've provided (All AMA employees must be logged in to submit requests)

Your email address

Your name

Subject(optional)

How can we assist you?

To ensure the best service for Internal End User licensees, please be sure to explain your issue in detail in the comments section.

Do you have a Distribution or Internal End User license?

What is the name of your organization?

Please list the name of your organization as it appears on your license agreement so that we can ensure we are reviewing the correct account.

AMA Contract ID(optional)

Please enter your AMA Contract ID so that we can ensure that we are reviewing the correct account.

What kind of contact change do you need to make?(optional)

New legal contact email(optional)

New legal contact name(optional)

New Primary Contact Name

Who should be contacted for follow ups?

New Primary Contact's Email

Comments or Questions

This is a required field. Please enter any additional comments or details that are necessary to complete this request.

Attachments(optional)

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