One Time Activity Accreditation Forms

The following forms may require Acrobat Reader. or Microsoft Word. If you are unable to access those forms, please contact our office at cme@upstate.edu.

CME Process Instruction Packet text

This packet describes each of the requirements for obtaining CME credit. It should be read before completing the program planning guide.

One Time Activity Planning Guide 

This packet will assist you in organizing information required by the Accreditation Council for Continuing Medical Education (ACCME) and help you in planning an educational activity. It must be submitted to the Office of Continuing Medical Education before credit can be granted.

Course Evaluation 

This is a sample course evaluation form that can be modified to fit the needs of your educational activity.

Speaker/Planner Disclosure Form 

Disclosure forms must be signed and submitted to the CME Office for each planner and speaker involved prior to the educational activity. Please review the ACCME Standards for Commercial Support.

Letter of Agreement 

A Letter of Agreement must be signed by a representative of the commercial supporter and submitted to the CME Office for countersignature prior to the date of the educational activity. Please review the ACCME Standard for Commercial Support.

ACCME Standards for Commercial Support

All educational activities must be developed and implemented independent of commercial interests. All commercial support, if applicable, must be managed appropriately.

Participant Log (MS Excel)

Participant's demographic information will be entered into this form and electronically submitted to the CME office. Individual Certificates of Participation will be provided on request.

Expense Report (MS Excel)

Final closing financial summary of the educational activity.