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CME Credit Application and Resources

Use these forms to have your educational activity certified for AMA PRA Category 1 Credits™.

Get more information about getting MOC Part 2 Points for your CME activity and CME credits at the UT College of Medicine (UTCOM).

CME Credit Application and Activity Summary - Use this form to apply to have your educational activity certified for AMA PRA Category 1 CreditTM.

Resources for the required attachments for the CME Credit Application:

  • Agenda for live activities and/or CME Product for on-demand content (video, booklet, audio, etc) - Your Agenda should provide us with the dates/times, topics & speakers, and your CME Product should include any intro pages, the CME content, bibliographic resources, the Evaluation page, and other pages that are part of the learner's experience. If you have not already created a digital Agenda for your activity, our Course Agenda template is a useful starting point for creating an agenda document for a course or conference, and ourSeries Agenda templateis a useful starting point an Agenda for a CME series with multiple sessions on various dates. You can submit existing brochures or other literature as your Agenda instead of the agenda formats above as long as your Agenda communicates the duration (session length), presentation topic or title, and speakers for each session for which you are seeking CME credit.
  • Planner & Speaker forms- All planners & speakers for a CME activity must complete their respective form below in order to disclose financial relationships (or the lack thereof) with ineligible companies, to agree to UTCOM policies for keeping the education free from commercial bias and promotion, and (speakers only) to keep the education evidence-based and provide their learning objectives.
    • Planner form - This form must be completed by the Activity Medical Director, Activity Coordinator, and anyone else in position to influence the planning, content, implementation, or evaluation of your CME activity.
      If someone is both a planner and a speaker, they only need to complete the Speaker form.
    • Speaker form - This form must be completed by the speakers/presenters, authors, moderators, and anyone else with a planned educational role for the CME content at your CME activity.
    • Speakers form for Case-Discussion Conferences - This form should be completed by the case presenters, moderator, and anyone else with a planned speaking role during your case-discussion CME activity. This form is shorter than the standard Speaker form because it does not include the third page that asks about learning objectives or audio/visual accommodations.
  • Marketing- All promotional materials - printed and digital (includes emails) - for your CME activity should be approved by the Office of CME prior to use or distribution, and promotion of CME credit for your activity is prohibited until the CME Credit Application has been approved by the Office of CME. The CME statements for your activity will be emailed to you when we approve your activity for CME credit, and they should be included on all marketing materials for your activity except brief save-the-date pieces. Our Tri-fold brochure template,Flyer template, andBi-fold brochure templateare basic starting points for creating those marketing pieces in Word document format for your CME activity if you do not already have these promotional tools for your activity.
  • Disclosures to Learners- A few pieces of information must be disclosed to the learners at your CME activity (per theDisclosures to Learnerssection of your CME Credit Application) via an intro slide, an activity handout (printed or digital), or a webpage (for online modules). You can add the disclosures to an existing activity handout/download if you have one, or our Disclosures to Learners PowerPoint Slide template is a good starting point for providing the disclosures on-screen to your learners and our Disclosures to Learners Flier template and CME Program Bi-fold template are great starting points for providing the disclosures via handout (printed or downloaded). Lastly, we also have aSeries Sign-in Sheet Template that can be used to provide the CME disclosures to learners at a series where learners simply sign-in and you don't need to gather their mailing address. Contact the Office of CME once you are ready for the Disclosures to Learners statements for your CME activity.
  • Activity Evaluation - The learners at your CME activity must be given an opportunity to evaluate the education (per the Activity Impact & Evaluation section of the CME Credit Application), and our Evaluation Template for a CME Course can be a useful starting point for creating a post-activity evaluation for a CME course.

For Regularly-Scheduled Series (RSS): AGeneric RSS Evaluation should be available at every meeting of a series to allow the learners to evaluate a session or provide feedback if they would like. Additionally, you should administer an evaluation at least twice a year to measure learning & gather feedback, and our Evaluation Template for a CME Series is a great starting point for creating an evaluation that you can administer at your RSS to allow learners to evaluate several meetings at once.

If your activity has more than 2 hours of CME content(per meeting):
Continuing Education Credit Request form - A continuing education credit request form or similar mechanism should be used for all CME activities with 2 hours or more of CME to have each learner confirm their participation time, and ourContinuing Education Credit Request form templatecan be a useful starting point for creating your form if you do not already have such a mechanism.

If you are receiving Commercial Support:
Letter of Agreement for Commercial Support -A Letter of Agreement must be signed by the commercial interest, the Office of CME, and the organization or department receiving commercial support for each disbursement of commercial support received for your CME activity. (See theCommercial Supportpage of the CME Credit Application to determine whether or not your revenues are categorized as commercial support for CME purposes.) Use ourLetter of Agreement for Commercial Support (Template)if the commercial interest did not provide their own letter of agreement.

Once your UTCOM-certified CME activity is over, visit theCME Activity Closeout webpage for guidance in submitting the conference closeout materials needed to issue the CME credit certificates/transcripts.

Nov 23, 2022