2026 Annual Meeting CME Claim Form

2026 Annual Meeting Evaluation Form

Virginia Chapter, American College of Surgeons | May 29 & 30, 2026 | Richmond, 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?
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
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?
Program Topics and content met the stated objectives.
Content was relevant to my educational needs.
Educational format was conducive to learning
This activity has improved my competence
This activity will improve my performance
This activity will enhance my communication skills
This activity will improve patient outcomes
This activity will improve processes of care and/or healthcare system performance.
Program was free of commercial bias
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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2026 Annual Meeting Evaluation Form