Before the Program

All materials must be presented to the CME Committee for the approval of your CME activity, before the advertisement and commencement of the program. Please plan to submit the materials 60-90 days ahead of the program.

For a one-time event, such as a conference or symposium, please complete the forms below:

• CME Application
• CME Application Process
• Speaker Planning Form
• Q&A Disclosures
• Planner / Speaker Disclosure Form
• Announcement of Disclosure Form (This should be distributed to the audience as a handout along with the evaluation form.)
• Evaluation Form

For events that are recurring or part of a series, such as Grand Rounds, please complete the forms below:

• CME Application
• CME Application Process
• CME Application Worksheet B
• Speaker Planning Form
• Q&A Disclosures
• Planner / Speaker Interval Disclosure Form
• Speaker's RFUMS CME Disclosure and Standard of Conduct
• Standards of Conduct and Disclosure of Financial Relationships Form
• Announcement of Disclosure Form (This should be distributed to the audience as a handout along with the evaluation form.)
• Evaluation Form for Grand Rounds
• Evaluation for Multiple Day Conference

For all events, whether one-time or recurring, the following materials should be submitted if applicable:

• Letter of Agreement/Commercial Support (If you are receiving any grants)
  The CME Office must know of all the commercial sponsors.
• Presentation Slides and Handouts
  The speaker’s presentation slides and any handouts that will be distributed during the event.
• Program Brochure/Flyer
  Announcement of the program. This is the brochure or flyer that you will mail/email to all target audiences or post on the web or bulletin. This should have the correct designation and accreditation statement, Objectives, Practice Gap/Need Assessment, Target Audience, Planner & Speaker Disclosures, Acknowledgement of Commercial Support, etc.
• Speaker CV/Abbreviated Biographical Sketch
  The name, title, academic position and contact information of the speaker if they are not CMS faculty.
• CME Certification Fee

After the Program

The following three items must be presented within two weeks after the program for the processing of CME credit. CME certificates will be mailed within 6-8 weeks after we receive the complete materials for each program.

1. Registration/Sign In Sheet
   Should include name, title and address of the participants. Please send as an electronic file.
2. Program Evaluation
   Two to three randomly selected evaluations by the participants.
3. Summary of Evaluation
   A numerical summary of the speaker/program evaluation. This should have the CME designation statement, objectives, elements of outcome and announcement of disclosures on it.
   • Summary of the Follow up Evaluation for Recurring Activities
   • Summary of the Followup Evaluation for Non Recurring Activities
   • Sample Follow up Evaluation for Conference
   • Memo for Completing Evaluation and Follow up Evaluation
   • Follow up Evaluation for Recurring Activities
   • Follow up Evaluation for Non Recurring Activities

Guides and Resources

Listed below are available guide sheets detailing tips and suggestions for completing the application forms: 

• Tips for Writing Learning Objectives
• Design Objectives and Need Assessment
• Tools to Ensure that Clinical Content is Valid
• Standards for Integrity and Independence Toolkit
• ACCME FAQ and Resources
• AMA Credit Designation Statement
• Regularly Scheduled Series Admin Training

Contact Elsa Kurien, MA, MEd, Director of CME, if you have any questions.