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                CHECK LIST OF REQUIRED FORMS & PROCEDURES FOR CME ACTIVITIES

I.        PRIOR to the Educational Activity, all applicants must provide to the CME Division:


         Completed CME Application including Gap Analysis documentation.

          A draft of the Brochure or Announcement for the program. For programs seeking CME credit,
      no announcements may be sent out without prior approval from the CME Division. (Template
      available upon request.) Please email us an electronic version of the text (Word or PDF) for our web
      site.

         Commercial Support in any amount must be reported to the CME Office. (Contact Teri Thomann
      at 319/353-3023 or teresa-thomann@uiowa.edu. If the support is for an exhibit fee only, we need the
      amount and the company providing the fee. (This Information can be emailed or voice mailed to us
      with the title of your conference.) If you are receiving a grant (in-kind or financial) from a
      commercial company, you must provide us with a completed Written Letter of Agreement for every
      grant. Each Agreement must be signed by the course director AND a representative from the
      company. This form has to be filled out, signed, and dated PRIOR to the activity taking place.

         Evaluation Form or process. You must have an evaluation strategy for every educational
      activity. Request a template from our office or submit your own for our review.

        Signed Joint Sponsorship Agreement (If applicable – only for jointly sponsored programs).
      Return to CME Division prior to the program.

         Disclosure of Relevant Financial Relationships. As of May, 2005 speakers, course directors,
      and planning group members must fill out and sign financial disclosures and return them to the
      program coordinator prior to the activity. However, disclosure is only part of the process: each
      disclosure must be reviewed for potential conflict of interest, and if any conflicts are found, they must
      be resolved. ANYONE WHO DOES NOT DISCLOSE MAY NOT PARTICIPATE IN A CME ACTIVITY.

         Disclosure of Commercial Support. Any funding provided to the educational activity must be
      disclosed to the audience. This may be done verbally or via a handout. (A template is available from
      the CME Division.)

         CME Fees and Charges. Please be sure to talk to CME staff to discuss the administrative fee
      and CME certificate charges for your meeting.




                                Please direct questions, comments, and inquiries to:

                   CME Division/The University of Iowa Carver College of Medicine/100 CMAB/
     Iowa City, IA 52242. 319/335-8599 (voice) 319/335-8327 (fax) http://www.medicine.uiowa.edu/cme/ (web)
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II.        DURING the Educational Activity:


          Faculty disclosures must be made known to the audience before each presentation. This may be
       done by verbal disclosure, a presentation slide, or a handout included in the syllabus and given to
       attendees before the program begins.
          All commercial supporters of the program must be disclosed to the audience.
          The course director, moderator, or coordinator must sign a Disclosure Review and Verification
       Form confirming that these disclosures and acknowledgments were made. A question needs to be
       included on the evaluation form asking attendees whether they detected any bias in the activity.


III.       FOLLOWING the Educational Activity (within two weeks):

          A list (alphabetized by last name) of all attendees requesting CME credit including full names,
       academic degrees (MD, DO, PA, ARNP, etc.), complete addresses, and phone number. All non-UI
       attendees MUST include their email addresses.

          A notation of the total number of attendees if only a certain percentage of attendees are
       requesting CME credit . We need to know how many of the total were physicians.

          A summary of responses to the evaluation questionnaires or pre- and post-tests given to
       attendees.

          Disclosure of Relevant Financial Relationships. Return to the CME Division all the faculty
       disclosures signed by speakers, the course director, and planning group members.

          Disclosure Review and Verification. The course director must sign this form, confirming that 1)
       he/she reviewed faculty financial disclosures prior to the activity and resolved any conflicts of
       interest; and 2) that all disclosures were made directly to the audience.

           Category 1 Change Forms completed by physicians who did not participate in the full program.

          A Financial Summary listing all revenues and expenses for the activity and how you made up
       any deficits. We ask that you use our financial summary template because it represents the data we
       have to report on.




                                Please direct questions, comments, and inquiries to:

                    CME Division/The University of Iowa Carver College of Medicine/100 CMAB/
      Iowa City, IA 52242. 319/335-8599 (voice) 319/335-8327 (fax) http://www.medicine.uiowa.edu/cme/ (web)

				
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