Board Review Course – CME/MOC Tracking Form This form is for tracking purposes only. Please track the sessions attended at the live course using the form below and complete the online CME evaluation and MOC quizzes to receive credit. Links to the evaluation and quizzes will be sent to the email address provided with your meeting registration. Further information for claiming credits is included below. NOTE: ACPM members attending the live course will receive complimentary CME and/or MOC credits, provided that the requisite evaluation and quizzes have been completed by October 6, 2014. Nonmembers requesting credits will be invoiced at $10 per CME or MOC credit. The $10 fee covers both CME and MOC credits, if requested. CME Course Saturday, August 23 □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ 2.50 □ □ 3.00 □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Biostatistics 5.00 Epidemiology 2.75 Sunday, August 24 Epidemiology (cont.) 2.00 Concurrent Discussions/Problem Solving Sessions 1.00 Concurrent Discussions/Problem Solving Sessions 1.00 Clinical Preventive Medicine 3.50 CDC Presentation 1.00 Monday, August 25 Clinical Preventive Medicine - Infectious Disease 2.25 Health Services Management (Systems-Based) 1.50 Health Services Management (Medical Economics) 1.50 Environmental Health 2.50 HHS-Prev Med in the Field of Federal Health Policy 1.00 Tuesday, August 26 Environmental - Fundamentals of Occ Med (Core) 3.00 Behavior and Mental Health 2.00 Aerospace Medicine Specialty Review Clinical Aerospace Medicine Occupational/GPM/PH Specialty Review Public Health Law MOC Wednesday, August 27 (CHOOSE ONE) Aerospace Medicine Specialty Review Management and Administration 1.50 Operational Aerospace Medicine 1.50 The Flight Environment 5.00 Public Health/GPM Specialty Review Chronic Disease 3.00 Health Services Management 2.00 CPM: Application of USPSTF 2.00 Occupational Medicine Specialty Review Hazard Recognition, Evaluation and Control 2.00 OEHS Administration and Systems-Based Practice 1.50 Clinical Occupational Medicine & Toxicology TOTAL CREDITS (Please provide or credits will not be issued) Max Credits: Aero-40.50, Occ-40.00, GPM-40.25 3.75 EVALUATIONS FOR CME AND MOC MUST BE COMPLETED BY OCTOBER 6, 2014. General Instructions:  Indicate the sessions attended at the 2014 Board Review Course in the left margin by checking the boxes in the CME or MOC columns, depending on the credits you intend to claim.  Total your credits on the final line for each category; this is the total CME/MOC credits that you will be awarded. To claim CME:  Access the electronic CME evaluation via the link sent to the email address provided with your meeting registration.  Complete the evaluation based on your notes in the left margin by October 6, 2014 to receive credit. When complete, you will receive a Thank You page acknowledging receipt of your evaluation.  CME certificates will be emailed 30 days post meeting. To claim MOC:  Access the electronic MOC quizzes via the link sent to the email address provided with your meeting registration.  Complete the quizzes based on your notes in the left margin by October 6, 2014 to receive credit. When complete, you will receive a Thank You page acknowledging receipt of your evaluation.  ACPM will report your credits directly to ABPM. Certificates will not be issued for MOC. ACPM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. ACPM designates this educational activity for a maximum of 40.50 (Aerospace), 40.00 (Occ.), 40.25 (GPM) PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 1