Planning a CME Activity

Forms for Developing a CME

Prior to initiating the application process, it is advised that you contact the CME Office to discuss potential dates, program ideas and content.

You may fill out these forms using Microsoft Word, except where signatures are required.

Click on the form name to download the form (in Netscape, you will open the form as "Read Only"). Save the form to your hard drive. Review any specific instructions the form provides. Fill in fields by positioning your cursor in the corresponding gray box (i.e., clicking in it or hitting the Tab key) and typing your response in it. The form fields will expand to fit your response.

To check a checkbox, click on it. To uncheck it, click it again.

When you are satisfied that you have completed the form, you may save it, print it and sign it, and submit it as indicated on the form.

Forms

• Form A: Application for Live Activity and/or Enduring Materials
• Form B: Application for Regularly Scheduled Conference (i.e., Grand Rounds)
• Form C: Faculty Disclosure Form
• Form D: Commercial Support Agreement
• Form E: Joint Sponsor Form
• Form F: Evaluation Form
• Form G: Regularly Scheduled Conferences Evaluation Form
• Form H: Policy for Identifying and Resolving Conflicts of Interest in CME

Guidelines

• Regularly Scheduled Conferences (e.g. Grand Rounds)
• Directly Sponsored Live Activity (Not Joint)
• Jointly Sponsored Single Event
• Directly Sponsored Enduring Material
• Writing Learning Objectives

Forms and Guidelines Bundled

• Forms A-H, and Guidelines Bundled (zip)

Web Sites

Ethical Guidelines for Gifts to Physicians From Industry

American Medical Association

ACCME Standards for Commercial Support

Documents above marked are viewable with the free Adobe^TM Acrobat^TM Reader. If you do not have Acrobat Reader, click on the image below to download it.