2025 Annual Meeting CME Claim Form

Evaluation Form

Virginia Chapter, American College of Surgeons | 2025 Annual Meeting | May 30 & 31, 2025 Virginia Beach, VA
TO RECEIVE A CME CERTIFICATE:Please complete this form no later than 15 days post conference.

AMA PRA Category 1 Credits™

The American College of Surgeons designates this live activity for a maximum of 8.75 AMA PRA Category 1 Credits™.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Learning Objectives

At the conclusion of this activity, the learner should be able to identify cutting-edge treatment for surgical issues, both general and subspecialty and comprehend the last information regarding clinical practice and research in the field of surgery.
Name*

First NameLast Name
Medical Credentials*
Your Email*
example@example.com
Are you a member of the American College of Surgeons?*

YesNo
ACS Membership Number: Credits will not post toyour ACS transcript inside the MyCME portal if ID is not provided *
State(s) you are licensed:
Are you claiming CME for this event*

YesNo
How many hours did you participate in this event? (max 8.75 Cat 1 credits)*
Max of 8.75
As a participant of this educational activity, I am claiming ____ hours of CME Credit. *Note: 15 minutes of session attendance = 0.25 AMA PRA Category 1 Credits™*
Max of 8.75
Overall, how would you rate this educational activity?

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Program Topics and content met the stated objectives.

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Content was relevant to my educational needs.

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Educational format was conducive to learning

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
This activity has improved my competence

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
This activity will improve my performance

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
This activity will enhance my communication skills

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
This activity will improve patient outcomes

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
This activity will improve processes of care and/or healthcare system performance.

Strongly AgreeAgreeNeutralDisagreeStrongly Disagree
Program was free of commercial bias

YesNo
If “no”, please explain instances of commercial bias:
How could this educational activity have been enhanced?
List a minimum of two things you are going to change as a result of what you have learned.
Describe the barriers anticipated when implementing the above changes.
Do you have any suggestions for future topics?
Do you have any suggestions for future meeting locations?
Additional Comments
Thank you again for attending the Annual Meeting!

Questions? Contact Susan McConnell at smcconnell@ramdocs.org or 804-622-8139.
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Evaluation Form