St. Louis Ophthalmology Society Continuing Medical Education Checklist

St. Louis Ophthalmology Society CME Checklist

This mandatory form will assist you in planning, implementing and evaluating your activity. Failure to complete the form may result in no Continuing Medical Education credit being awarded for the activity.
ACTIVITY INFORMATION
Title of Continuing Medical Education Activity:*
Date of Activity:*

MonthDayYear
Date
If this activity has multiple formats, please defined type of activity for specified date:

Grand RoundsJournal ClubCase Conference or Tumor BoardM&M
Activity Coordinator Name:*

First NameLast Name
Activity Coordinator E-Mail:*
example@example.com

St. Louis Ophthalmology Society CME Checklist