Forms & Documents
| Title | Description | Who Should Download? |
|
Joint-Sponsor Questionnaire (PDF document) |
Use this form if you are interested in collaborating with UNTHSC on CE activities | Potential joint sponsors |
|
Joint-Sponsor Activity Questionnaire (Word Document) |
Use this form to request UNTHSC review a proposed activity for potential joint sponsorship or co-providership. | Potential joint sponsors or others with an idea for an activity that meets an identified need. |
| Performance improvement (PI) CME activities describe structured, long term processes by which a physician or group of physicians can learn about specific performance measures, retrospectively assess their practice, apply these measures prospectively over a useful interval, and re-evaluate their performance. | Anyone with an idea or specific need for a continuing education activity | |
| Department liaisons should use this form to report preceptor credit to the PACE Office. | Clinical/Educational Department Liaisons | |
| Department liaisons should use this form to report teaching credit earned by faculty members to the PACE Office. | Clinical/Educational Department Liaisons | |
| Hospital Education Representatives with whom PACE works should use this form to report educational activities at a healthcare facility. | Hospital Education Representatives | |
| Use this form to request credit for a UNTHSC-sponsored activity you have attended if you have misplaced the form you received at the activity. | Healthcare providers requesting credit for a CME or CE activity | |
| Use this form to document PRA AMA Category 2 credits in your files | AMA-member physicians who have earned category 2 CME credits (not sponsored by an accredited provider) | |
| General form for faculty members requesting travel expenses or speaker fees | CME or CE faculty members who have misplaced the original expense report | |
| UNTHSC's policy on identification and resolution of conflict of interest | Any internal or external presenter, reviewer, writer, planning committee member or joint sponsor. | |
| UNTHSC's standard Letter of Agreement for Commercial Support | Potential commercial supporters | |
| Faculty disclosure and conflict resolution form | Presenters at a CME or CE activity. | |
| Use this form to suggest a CME-certified printed monograph. | Original authors or co-authors | |
| Use this form to submit a CME-or CE-certified presentation you would like to provide. | Potential presenters | |
| Request a transcript or certificate for UNTHSC-sponsored activities | Activity participants | |
| The most current Standards of Commercial Support released by the ACCME | Commercial supporters, joint sponsors and/or attendees | |
| A listing of CME requirements by state | Physicians | |
| Rand Horsman Staff Scholarship | $1,000 scholarship to provide assistance for a Health Science Center (HSC) employee and/or an employee’s dependent who are continuing their education. | Health Science Center (HSC) employee and/or an employee’s dependent who are continuing their education |
This page last updated Oct 19, 2012
