Steps to Certification of Your One-Time Activity

Prior to the Activity

STEP 1

CONTACT CME OFFICE

  • For initial discussion about your plans
  • Please note all documentation must be submitted electronically

STEP 2

FILL OUT APPLICATION FORM

  • Application Word document MUST be submitted at least 8 weeks prior to the date of the proposed activity (application turned in less than 8 weeks prior to the activity date will incur additional fees and may not be approved)
  • Application must be turned in electronically as an attachment to an E-Mail
  • Partially completed applications will be returned

STEP 3

SUBMIT COMPLETE LIST OF PLANNERS AND SPEAKERS

  • Each planner and speaker must submit a signed disclosure form Word document
  • Disclosure of financial relationships pose potential conflict of interest which must be resolved
  • Activity Director must resolve the potential conflict by taking action and filling out the Resolution of Conflict portion of the disclosure form at the bottom, if applicable
  • Review ACCME Standards for Commercial Support External link
  • Each disclosure form must be signed, dated and turned in to the CME Office prior to the approval of the activity. Failure to submit completed forms may result in credit being withheld from portions of he activity.

STEP 4

COMMERCIAL SUPPORT

  • If you are seeking commercial support please review ACCME Standards for Commercial Support
  • Contact the CME Office for further discussion and counsel
  • A Letter of Agreement Word document must be signed by a representative of the grantor and the CME Office

STEP 5

SUBMIT A COPY OF YOUR EVALUATION TOOL

  • It is required that each educational activity be evaluated
  • Evaluation Word document tools must be approved by the CME Office

STEP 6

SUBMIT MARKETING PROOF

  • Submit a copy of your flyer/brochure or save-the-date for approval by the CME Office prior to distribution
  • Save-the-date announcements may be distributed prior to formal approval of your activity but cannot mention that credit has been applied for or is pending
  • Each flyer/brochure must contain the following:
    1. title, date, location, time
    2. target audience
    3. learning objective
    4. faculty listing and credentials
    5. faculty and planner disclosures (if financial relationships exist, the name of the financial interest and the nature of the relationship must be listed, if no financial relationships exist, this must also be state)
    6. disclosure policy
    7. ADA statement
    8. acknowledgment of commercial support, if applicable
    9. accreditation/designation statement (wording must be exact as follows - trademark must be either in italics or bolded)
If directly sponsored:

UPSTATE Medical University is accredited by the ACCME to provide continuing medical education for physicians.

UPSTATE Medical University designates this live activity for a maximum of (insert # of credits offered) AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity.
If jointly sponsored:

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of UPSTATE Medical University and (insert name of joint sponsor). UPSTATE Medical University is accredited by the ACCME to provide continuing medical education for physicians.

UPSTATE Medical University designates this live activity for a maximum of (insert # of credits offered) AMA PRA Category 1 Credit(s). Physicians should claim only the credit commensurate with the extent of their participation in the activity.

STEP 7

SUBMIT A DRAFT OF YOUR SYLLABUS/AGENDA

  • must include start and end times for each section

The CME Office will review and approve your activity within 7 business days from the date ALL documentation is received.

Post Activity

SUBMIT THE FOLLOWING DOCUMENTATION

  • Attendance log (electronic copy submitted on forms provided by the CME Office)
  • Evaluation summary (you may elect to have the CME Office tabulate your evaluations for an additional fee)
  • Final copy of brochure
  • Final expense report to include list of all income and expenses
  • Exhibitor registration forms
  • Copies of commercial support checks and exhibitors fees, if applicable
  • Copies of slides not previously submitted

Forms

One Time Activity Application Word document
Course Evaluation Word document
Disclosure Word document
Letter of Agreement Word document
Attendance Log Excel document
Final Expense Report Excel document
ACCME Standards for Commercial Support PDF document
ACCME Essential Areas and Elements PDF document