ACOEM Webinar Submission Form
ACOEM welcomes your ideas for future webinars! Webinars are currently delivered through Zoom, are typically one hour in length and the recommended day and time are Tuesdays at Noon CT. There is flexibility with the length (up to 1.5 hours), day and time. If you are interested in proposing a longer activity, please email us at webinars@acoem.org.
Primary Contact for Webinar:
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First Name
Last Name
Email:
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example@example.com
On behalf of (if applicable):
ACOEM Section or Component
If this is a section webinar, please indicate who can attend:
Section Members only
All ACOEM Members only
ACOEM Members (free) and ACOEM Non-members ($25 fee)
What date would you like to present this webinar:
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Month
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Day
Year
Date
What time would you like to present this webinar (Please use Central Time):
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6
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12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/PM Option
Do you intend to offer CME for this webinar?
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Yes
No
Webinar Title:
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Faculty Names, Credentials, Position:
Brief Description of Webinar Content (to be used in marketing):
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i.e. what makes this event unique?; what is appealing about this webinar?
Learning Objectives (need 2-3 objectives which should follow, "Upon completion of this activity, participants should be able to):
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For more information on writing learning objectives, please
click here
.
Who is the target audience for this webinar?
OEM Physicians
Urgent Care Physicians
OEM Physician Assistants, Nurse Practitioners, Other Advanced Practitioners
Occupational Health Nurses
Industrial Hygienists
Safety Professionals
Which of the following formats/methods will you use to engage attendees?
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Q & A at end
Breakout rooms
Poll questions
Panel discussion
Add in video content
In the context of which of the following OEM competencies will this webinar be developed? Click all that apply.
Clinical Occupational and Environmental Medicine
OEM Related Law and Regulations
Environmental Health
Work Fitness and Disability Management
Toxicology
Hazard Recognition, Evaluation and Control
Disaster Preparedness and Emergency Management
Health and Productivity
Public Health, Surveillance, and Disease Prevention
OEM Related Management and Administration
Identify the practice gaps that this webinar will address:
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Find more about practice gaps by visiting the ACCME website here: https://www.accme.org/resources/video-resources/accreditation-requirements/addressing-practice-gaps
Submit
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