Emergency Medicine Board Review Course CME Tracking Form - 5 day

Ohio ACEP Emergency Medicine Board Review Course

(Contact Ohio ACEP by calling (614) 792-6506 to redeem CME for a previous year's course.)
February 6-10, 2014
August 18-22, 2014
October 6-10, 2014
January 26-30, 2015
It is possible to earn up to 50 hours of AMA PRA Category 1 CreditsTM for the 5 day course.
It is the responsibility of each registrant to keep track of the hours he/she has spent on each portion of this course. Physicians should claim only credit commensurate with the extent of their participation in the activity.
You must complete the form below to receive a CME certificate. You should receive it by e-mail within 14 business days after submitting your hours.
If you submit information and do not receive your CME certificate, first please check your spam/junk mail folder, then call or e-mail the Ohio ACEP office; please DO NOT resend your request. Thank you.
Ohio ACEP Emergency Medicine Board Review Course
First Name
Last Name
Credentials (MD, DO, FACEP, FACOEP, RN, PA, etc.)
Preferred Phone Number
E-mail Address
Course Attended
(Hours Available)/Hours Spent
Didactic Lectures (48)
Day 2 e-learning Review (1)
Day 3 e-learning Review (1)
Total Hours Available: (50) Total Hours Reported
   - denotes required fields