CME Credit Application and supporting resources
Use the forms below to have your educational activity certified for AMA PRA Category 1 Credits™ and other types of CME credit. Click here for more information about 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 and other types of CME credit. NOTE: This form is updated every few weeks, so please download the latest version if you have not downloaded it in several weeks.
CME Activity Application Resources
Required Attachment #2) Agenda - You must provide a detailed conference agenda with your CME Credit Application & Activity Summary. Our agenda template can be a useful starting point for creating one if you do not already have one. You can submit brochures or other promotional materials as your agenda instead as long as they contain the start time, end time, duration (session length), presentation title, and presenter name for each educational session.
Required Attachment #3) Commercial Independence forms - Everyone affiliated with the planning or presentation of your CME activity has a responsibility to ensure that the educational content is free from commercial bias. Use the forms below to disclose financial relationships with commercial entities (or lack therof), to agree to UTCOM policies for Commercial Independence, and (speakers only) to list your presentation objectives.
Commercial Independence form for Planners - This form must be completed by the planning committe member(s), activity medical director(s), activity coordinator(s), and anyone else in position to influence the planning, content, or outcome of your UTCOM-certified CME activity.
Commercial Independence form for Speakers - This form must be completed by the introducer(s), presenter(s), moderator(s), and anyone else in a speaking role for your UTCOM-certified CME activity.
Required Attachment #5) Activity Evaluation - CME activities must be evaluated by conference participants. Our Evaluation Template for Single-Session CME Activities can be a useful starting point for creating a post-activity evaluation for a CME activity with only one speaker, and our Evaluation Template for Multiple-Session CME Activities can be a useful starting point for creating a post-activity evaluation for a CME activity with multiple speakers & presentations. Other types of evaluations can be used for your CME activity instead or in addition to a post-activity evaluation. (see page 6 of the CME Credit Application and Activity Summary ↑ for more information on evaluations)
Required Attachment #6) Disclosures to Learners, handout - Our Disclosures to Learners handout template is a great starting point for a handout that contains the 4 pieces of information must be disclosed to the learners at your CME activity: 1) learning objectives, 2) AMA Credit statement & Accreditation statement, 3) any commercial support received for the activity, and 4) the relevant financial relationships (or lack thereof) for all speakers. This handout just provides a quick starting point for activity coordinators who do not already have a disclosure handout, so you are certainly welcome to use your own handouts instead of this template. The important thing is just that you provide us with a handout that will be given to learners that discloses this information.
If your activity has more than 2 hours of CME content:
Required Attachment #7) Credit Declaration - A credit declaration form should be used for all conferences with 2 hours or more of CME, to allow attendees to declare which educational sessions they attended. Our Credit Declaration template can be a useful starting point for creating your credit declaration form.
If you are receiving Commercial Support:
Required Attachment #8) Letter of Agreement for Commercial Support - You must complete and sign this Letter of Agreement for each disbursement of commercial support (eg, an educational grant) received for your CME activity.
Once your UTCOM-certified CME activity is over, visit the CME Activity Closeout webpage for guidance in submitting the conference closeout materials needed to issue the CME credit certificates/transcripts.