CME form Form Preview
  • UCHealth Memorial Hospital CME

    Brandy.Swennes@UCHealth.org Phone: (719) 365-6850
  • Multi-presentation/Event Application Form

    NOTE: All material must be submitted 60 days prior to event.

    If you are considereing ANY financial support for the program (grants, commercial support, meals) please contact the office of CME BEFORE completing this application

  • Application Directions

    UCHealth - Memorial Hospital is accredited by the Colorado Medical Society to certify continuing medical education activities for physicians. When AMA PRA Category 1 credit™ is awarded, it is required by accreditation standards to document program development and implementation, and to ensure that the activity meets all nationally established CME Guidelines.

    CME activities must be designed to change competence, performance, or patient outcomes as described in the CME mission statement:

    "The mission of the Memorial Hospital- University of Colorado Health Continuing Medical Education Program is to provide lifelong learning experiences for physicians and healthcare teams that support their efforts to enhance the safe, timely, equitable, efficient, effective, and patient-centered delivery of health care."

    Application Process:

    To apply for CME certification, a completed application and supporting documentation are required and should be submitted as an electronic document. CME department involvement must be initiated and application approval received prior to the confirmation of faculty and final program development. A minimum of 60 days will be needed to review a completed application. Formal written approval by the CME Department is required prior to advertising CME credit.

    The CME department is available to assist with questions about the application and to provide supporting materials.

    Please submit the following application electronically OR return completed packet to:

    UCHealth CME Department

    Atten: Brandy Swennes

    1400 East Boulder

    Colorado Springs, CO 80909

    (719) 365-6850

    During the application process you will be asked to:

    1. Complete the online application
    2. Complete the attached Conflict of Interest form for the individual submitting the application - all speakers and planners will also need to complete a Conflict of Interest form (Found on the UCHealthmemorialCME.org website)
    3. Upload an evaluation form. A sample form can be found on the UCHealthmemorialCME.org website
    4. Upload a proposed agenda

    1. Requirements for submitting an Activity Development Form

    At least one UCHealth - Memorial Hospital faculty member, either full time or clinical, must be the Activity Director or significantly involved in the activity planning (and listed as a planning committee member).

    2. Outcomes Measurement

    Outcomes measurement is essential to the educational process. Every activity receiving Category 1 credit must be evaluated. Outcomes-based evaluation or measurement looks at impacts/benefits/changes to your attendees (as result of your educational activity) during and/or after their participation in your activity.

    The following items must be components of any evaluation process.

    • Participants must be requested to evaluate activity presentations and content in terms of stated practice gaps (need) and learning objectives. All feedback, written and verbal, should be assessed to determine if objectives were met.
    • Changes in learners (competence, performance, or patient outcomes) achieved as a result of the overall program's activities/educational interventions.
    • Participants must be requested to evaluate commercial bias in the delivery of educational content. Sample questions are available upon request.
    • A typed, substantive summary of the evaluation responses and outcomes measures must be provided to the CME Department. The summary, in combination with feedback provided by the planning committee, should be used to make recommendations for future programming

    3. Activity Announcements

    • Any announcement, if it references the maximum number of credits for which the provider has designated the activity, must clearly include the complete Accreditation and Certification statements (see below).
    • Publicity may not be printed or distributed until written confirmation is received from the CME Department that the activity has been approved for credit. A Save the Date or preliminary announcement with no reference to CME may be released prior to formal activity approval. It is not permissible to state on any activity announcements that application has been made for Category 1 credit or that CME credit has been applied for or CME credit is pending. The final draft of all activity announcements must be reviewed and approved by the CME Department before printing. A “save the date” announcement (such as a card mailer with limited space) may indicate that AMA PRA Category 1 credit will be provided without stating the exact amount, but only if the provider has already certified the activity. This announcement may read, “This activity has been approved for AMA PRA Category 1 Credit™.”


    Memorial Hospital: University of Colorado Health is accredited by the Colorado Medical Society to provide continuing medical education for physicians.

    Jointly Provided Activities – Please contact the Brandy Swennes for specific announcement requirements.

    Please refer to the following websites for additional information
    American Medical Association Information about AMA PRA Category 1 credit™ www.ama-assn.org

    Accreditation Council for Continuing Medical Education www.accme.org