MEDIC: CME TYPE II ENTRY FORM

Registration of CME Category II or Outside Category I Activity


Please note: for outside Category I or II activity you should maintain your certificate and/or documentation for your records. The listing here is provided only for your convenience.

Type of CME:			    Category I  Category II

Enter user ID name:		

Enter password:		            

Enter Date:  Month (01-12)     Enter Day (01-31)     Select Year   

Enter Clock Hours:		

Enter Activity Title:              

(<50 characters)
Enter Activity Type:



Released: 1/4/95, Last Reviewed: 1/30/95, UT DPALM MEDIC, copyright © 1995