AAO CME Attestation

Use this form to verify CME credits for the AAO. Only one course may be verified at a time.

The AAO will report your CME credits to the American Osteopathic Association (AOA) on your behalf within 60 days of the course date. Use the AOA's TraCME Service to view your CME Activity Report at any time.

In order for credits to be successfully processed, the AOA number, Physician's Last Name, and Physician's First Name must match what the AOA has listed in their database.

You will receive a copy of this CME attestation via email for your records.

Name*

First NameLast NameSuffix

AOA Number*

Email*

example@example.com

Select CME Course Attended*

Type a question

Course Date

CME Hours Eligible

Confirm Hours Attended*

CME Hours Earned

Max hours are listed on your flier

The parties agree that this document may be electronically signed. The parties agree that the electronic signatures appearing on this document are the same as handwritten signatures for the purpose of validity, enforceability, and admissibility.

If you prefer to sign this document manually, please print and remit this completed form with your handwritten signature to AAO event planner, by email at eventplanner@academyofosteopathy.org by fax to (317) 879-0563.

Electronic Signature*

Type your signature to verify your CME attestation.

The American Academy of Osteopathy reserves the right to make and issue corrections to submitted CME attestation as necessary. Please be sure to double check the CME hours entered before submitting. Unless otherwise stated, earned CME hours will only be reported to the AOA for the approved and eligible CME hours for the course.