Pre-Activity Checklist
- REQUEST FOR AUTHORIZATION WITH LIST OF COMMITTEE MEMBERS. CME application including gap analysis, statement of need, objectives with proper action verbs
- DOCUMENTATION OF PLANNING
- BROCHURE/MARKETING MATERIAL. All marketing material (save-the-date, brochure/invitation, website, e-mail, etc) must be reviewed and approved by the CME office prior to printing/posting. Please refer to Required Elements for Syllabi/Brochures for the required information.
- CV or BIO FOR ALL FACULTY (e.g. Planning Committee Chair, Planning Committee members, Speaker(s))
- CME/CE DISCLOSURE. All planning committee members, speakers/presenters/moderators, etc. are required to complete a CME disclosure form. Please use this Faculty Disclosure Statement form.
- RESOLUTION OF CONFLICT OF INTEREST (COI). Copy of the Speaker(s) presentation (slides, etc.). Please refer to Requirements for Development of CME Presentations.
- COMMERCIAL SUPPORT/CME GRANT LETTER OF AGREEMENT (LOA): Commercial support (e.g., food at meetings, speaker honoraria, travel, etc.) must be supplied in the form of an educational grant). LOAs must be signed by the commercial supporter and submitted to SJH CME for approval prior to the activity.
- EVALUATION: The CME activity must be evaluated by learners. Please use this evaluation template form.
- CERTIFICATE OF ATTENDANCE form. Physician and Non-Physician
- SYLLABUS/CME INFORMATION: A syllabus and/or other means of communicating CME information to learners must be created prior to each activity. Please refer to the Required Elements for Syllabi. The syllabus/CME information document must be emailed to our CME Coordinator for review and approval prior to printing.
NOTE: All participants must be provided with a copy of the syllabus/CME information document prior to the start of the activity.
Post-Activity Checklist
The following must be submitted to SJUMC CME at cme@sjhmc.org after the CME activity within 14 days.
- SIGN-IN SHEETS or ATTESTATION FORMS: We cannot accept check marks for signatures. Send completed sign-in sheets via fax, email or regular mail to the CME Coordinator as soon as possible following the activity.
- MARKETING MATERIALS:
- Brochure/Invitation – 2 copies of the final printed product
- Syllabus – 2 copies of the final printed product with all slides, handouts, etc.
- COMMERCIAL SUPPORT DOCUMENTATION
- Copy of Grant Checks required, if applicable
- Copy of Exhibit Checks required, if applicable
- EVALUATIONS (if paper-based)
- FINAL BUDGET RECONCILIATION with actual expenses and income listed. Please use this budget reconciliation form.
