CME Report Form


Please complete the entire form and click 'Submit' when finished. Your responses will be kept strictly confidential.

If you have questions about this form please contact the ACR Office of Chapter and Volunteer Development at 800-401-1438 or at chapters@acr.org.

Thank you for your participation.

Name:
Position in Chapter:
Chapter Name:
Description of program offering CME credit Type of CME credit offered What ACGME accredited organization cosponsored the event? Number of credits offered

Thank you for completing the CME Report Form.

Please contact the ACR Office of Chapter and Volunteer Development with questions or concerns at either chapters@acr.org or 800-401-1438.