TOA's Online Opioid Prescribing CME

2022 TOA Annual Conference Continuing Medical Education Reporting Form April 22-23, 2022

3.00 CME hours available for Friday AM | 5.00 CME hours available for Friday PM | 5.5 hours available for Saturday
You do not need to fill this out for each day.

You may simply complete this form one time
for the entirety of the meeting.

Thank You!
INSTRUCTIONS
1. Form to be used for recording CME Credit Hours of attendance at Texas Orthopaedic Association programs/courses. This CME Reporting is for the 2022 TOA Annual Conference live activity held April 22-23, 2022.
2. Record each program/course/workshop attended and the number of credit hours. Credit hours are based on hour-for-hour attendance.
CME Accreditation and Credit Designation: Texas Orthopaedic
Association is accredited by the Texas Medical Association to provide
continuing medical education for physicians.

Texas Orthopaedic Association
401 West 15th Street #820
Austin, Texas 78701
(512) 370-1505 • (512) 370-1515 (fax)
Name*

First NameLast Name
Suffix (MD, DO, RN, PA or n/a etc)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
13.50 CME hours were available for the attending the entire meeting:

Friday AM: 3.00

Friday PM: 5.00

Saturday: 5.50

1 hour of ethics CME hours were available for the meeting:

(.50) Friday 8:00 am - 8:30 am

Anatomy of a Lawsuit
T. Marc Calvert, JD

(.50) Saturday 12:00 pm - 12:30 pm

AAOS Presidential Line
Kevin J. Bozic, MD
# of hours you are claiming for your attendance?
# of hours of Ethics you are claiming for your attendance?
I certify to the best of my knowledge that the above information is correct. *

YesNo
Thank you!

Your CME Certificate will be
emailed to you at a later date.
Please enter today's date:*

MonthDayYear
Date
Should be Empty:

2022 TOA Annual Conference Continuing Medical Education Reporting Form April 22-23, 2022