ABIM Peer Review form

Peer Review

Verification for ABIM MOC II Activities
Name of reviewer*

FirstLast
Activity name*
Date of activity*

MonthDayYear
Please complete the following based on your review:
Activity content is relevant to physicians certified by ABIM.*

YesNo
Activity design is appropriate.*

YesNo
Activity is fair and balanced.*

YesNo
On the basis of the information provided, I have determined that this activity is*

Acceptable for CME /MOC 2 creditsAcceptable with revisions for CME/MOC 2 creditsNot acceptable for CME /MOC 2 credits
Suggested revisions:*
Reason:*
As a reviewer for the provided content, you attest that you are a clinician who is sufficiently familiar with the material to assess whether the materials are fair, accurate, and free of commercial bias.
Reviewer's email*
Date*

MonthDayYear
Should be Empty: