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Upstate Medical university Continue Medical Education

Regularly Scheduled Conference 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.

RSC Annual Renewal MS Word   PDF

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

RSC Quarterly Evaluation MS Word    PDF

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

Conflict of Interest Disclosure PDF document text

The COI form records relationships with commercial entities and must be completed by all faculty and individual involved in the planning who can control the CME content of a CME activity. All Conflicts of Interest must be resolved before the faculty can proceed in the planning process.

Departments with in SUNY Letter of Agreement: MS Word   PDF
or Non SUNY Departments Letter of Agreement: MS Word   PDF

These forms document the agreement between SUNY CME and the commercial entity financially supporting an educational activity. It must be completed by each commercial entity supporting a CME activity. All other agreements or contracts must be reviewed by the CME office.

Excel Participant Log (MS Excel Document)

CME contact will submit electronically an Excel log identifying participants at each RSC. This ">credits will be maintained by the CME office. Transcripts will be furnished upon request.

Financial Summary (MS Excel Document)

Yearly financial summary of the Regularly Scheduled Conference.