Hillsboro Medical Center Grand Rounds Evaluation/Attendance

Date you attended*

MonthDayYear

I attended in person.I attended via livestream.

ExcellentGoodFairPoor

YesNo

Please describe the commercial bias you observed.

YesNo

If yes, please describe:

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Name as you want it to appear on your credit certificate:*

First NameLast Name

Degree*

Email*

Date of Birth - Month and Day (MD and DO's Only)

(New ACCME Requirement)

Medical License Number (MD and DO's only)

(New ACCME Requirement)

License State (MD and DO's only)

(New ACCME Requirement)

Accreditation: This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of OHSU School of Medicine and OHSU Health Hillsboro Medical Center. The OHSU School of Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Credit: Oregon Health & Science University School of Medicine designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.