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CME Credit Application and Resources

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

Click herefor more info about getting MOC Part 2 Points for your CME activity.  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.  

Resources for the required attachments for the CME Credit Application:

1) Agenda - You must provide a detailed agenda for your CME activity, so that we have record of its dates, topics, speakers, etc. OurCourse Agenda template is a useful starting point for creating an agenda for a course, conference or symposium with one or more topics & speakers if you do not already have one, and ourSeries Agenda template is a useful starting point for creating an agenda for a CME series with multiple sessions on various dates if you do not already have one. You can submit existing brochures or other literature as your agenda instead of the agenda formats above as long as your agenda includes the duration (session length), presentation topic or title, and speakers for each session for which you are seeking CME credit.

2) Commercial Independence 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 commercial entities, to agree to UTCOM policies for independence from commercial bias, and (speakers only) to list your presentation objectives. 

a) Commercial Independence form for Planners - 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 UTCOM-certified CME activity. 

b) Commercial Independence form for Speakers - This form must be completed by the speakers/presenters, moderators, and anyone else with a planned speaking role during the CME sessions at your CME activity. 

c) Commercial Independence form for Speakers at Case-Discussion Conferences - This form is designed to be completed by the case presenters, moderator, and anyone else with a planned speaking role during a case- or journal-discussion CME activity.  This form is shorter than the Commercial Independence form for Speakers because it does not have the third page asking about learning objectives or audio/visual accommodations.

If someone is a planner as well as a speaker, they only need to complete the Speaker form. 

3) Marketing - All promotional materials - printed and digital - for your CME activity must be reviewed & approved by the Office of CME prior to use or distribution, and promotion of CME credit for this activity is prohibited until the CME Credit Application has been approved by the Office of CME.  Our Tri-fold brochure template,Flyer template, andBi-fold brochure template are great starting points for creating those marketing pieces for your CME activity if you do not already have these promotional tools for your activity.

4) Disclosures to Learners, handout -  A few pieces of information must be disclosed to the learners at your CME activity (see the Disclosures to Learners section of the CME Credit Application for more info).  The Program publication/handout for your CME activity is a great place to include the disclosures, and you can just add the necessary disclosures to your existing Program if you already have one or our Disclosures to Learners Flier template and CME Program Bi-fold template are great starting points for creating a handout that includes them if you don't already have one for your activity. Lastly, we also have aSign-in Sheet Template that includes the Disclosures to Learners (intended for regularly-scheduled series) that allows you to provide the CME disclosures on your sign-in sheets, all on one handout.  

5) Activity Evaluation - The learners at your CME activity must be given an opportunity to evaluate the education (various types of evaluations can be administered), but please see the Activity Impact & Evaluation section of the CME Credit Application & Activity Summary for detailed information on the Evaluation requirements for your CME activity.  Our Evaluation Template for CME Courses with One Speaker can be a useful starting point for creating a post-activity evaluation for a CME activity with only one presentation, and our Evaluation Template for CME Courses with Multiple Speakers can be a useful starting point for creating a post-activity evaluation for a CME activity with multiple presentations. 

For Regularly-Scheduled Series (RSS):  A Generic Single Meeting RSS Evaluation should be available at every RSS meeting to allow the learners to evaluate the meeting if they would like. Our Evaluation Template for Multiple RSS Meetings 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):
6) Continuing Education Credit Request form - A continuing education credit request form (or similar attendance verification mechanism) should be used for all conferences with 2 hours or more of CME in order to allow attendees to declare which educational sessions they attended.  Our Continuing Education Credit Request form template can be a useful starting point for creating your form if you do not already have one.

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

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.

Last Published: Feb 11, 2021