Letter of Intent (LOI) Template Please: 1.Prepare this Letter of Intent on your Institutional Letterhead, 2.

Sign the letter, and sa e it in PDF Format, !."omplete the atta#hed LOI Information Pa#$age, %.Send the Letter and LOI Pa#$age via email to blondell@buffalo.edu (write ABAM Foundation LOI in subject line) by September 8, 2010

date! "ic#ard $. Blondell% M.$. &#air% 'rainin( ) Accreditation &o**ittee '#e ABAM Foundation $e+art*ent of Fa*ily Medicine% ,-./ at Buffalo 012 3rider ,treet% "oo* &&4567 Buffalo% ./ 5025048925 $ear $r. Blondell% As t#e [enter title as institutional official]% I co**it t#e [institution] to see: +ro(ra* accreditation wit# t#e A*erican Board of Addiction Medicine (ABAM) Foundation for t#e start of an Addiction Medicine residency by ;uly 5% 2955. If accredited by t#e ABAM Foundation% we ulti*ately will wor: wit# t#e Foundation to see: accreditation by t#e Accreditation &ouncil for 3raduate Medical <ducation (A&3M<). '#e [institution] #as [X number of other medical specialties give examples] accredited by A&3M< and we #a=e a lon( trac: record of acco*+lis#*ents in areas of [brief list of related capabilities]. Our +ro+osed >ro(ra* $irector will be [PD name]% w#o is well ?ualified wit# [summary of credentials]. Ot#er +artici+atin( faculty will be [faculty list with credentials]. @e #a=e co**it*ents fro* =arious addiction treat*ent settin(s [describe extent of commitments; describe facilities and settings] for resident rotations. If in=ited to a++ly% we will sub*it a >ro(ra* Accreditation A++lication For* (>AAF) for ABAM Foundation Accreditation by .o=e*ber 5% 2959. @e #a=e t#e eA+erience [describe recruitment strategy] to recruit at least one Addiction Medicine "esident by ;uly 5% 2959. @e furt#er #a=e institutional resources and financial co**it*ents [describe specifics] +lanned to su++ort t#e startu+ of t#e +ro(ra*. It is understood t#at if we beco*e an ABAM Foundation accredited +ro(ra* and are a*on( t#ose selected for financial su++ort% and if t#e ,tate -ni=ersity of .ew /or: at Buffalo recei=es t#e (rant award for w#ic# it will a++ly on be#alf of t#e ABAM Foundation% we a(ree to contract wit# t#e ,-./ at Buffalo for su++le*ental startu+ su++ort u+ to B599%999 o=er two years for +ro(ra* eA+enses t#at do not su++lant institutional resources described abo=e. @e loo: forward to t#e o++ortunity to be a full +artici+ant in t#is national initiati=e to establis# Addiction Medicine "esidency trainin( +ro(ra*s. ,incerely% [institutional official name] [institutional official title]