2021 Initial Request

AAOS CME Joint Providership

Initial Request Form
INITIAL REQUEST
Date of Request: *
Organization Name *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Contact Person *

First Name Last Name
Email Address *
Telephone *

Area Code Phone Number
Joint Providership is requested for the following CME activity:
Type of Activity *

Live Course/meeting
Activity Title *
Start Date *
End Date *
Location (City/State) -if applicable
Program Chair/ Editor *

First Name Last Name
You are responsible for obtaining current financial disclosure information from the Planning Committee & Staff involved in the education planning process using the AAOS Disclosure Database. Planning Committee/staff disclosure information must be current within the 12 months preceding the start of the CME activity of {startDate}.
Planning Committee (please list) *
Please upload disclosures for all Planning Committee/Staff *

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Cancel of
Please upload all Preliminary Program/Agenda documents *

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Cancel of
Begining January 1st, 2022 there are new Standards for Integrity and Independence in Accredited Continuing Education that we must abide by. If you have any questions please reach out to us here at AAOS.
Thank you!
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AAOS CME Joint Providership