Arizona Osteopathic Medical Association 95th Annual Convention

ATTESTATION AND EVALUATION FORM

IMPORTANT INSTRUCTIONS BELOW

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Upon successful completion and verification of each attestation, your CME hours will be logged to your Professional Development record in your account profile on the AOMA website.  Your AOA number is required to complete the form.  

The Arizona Osteopathic Medical Association (AOMA) is accredited by the American Osteopathic Association (AOA) to provide osteopathic continuing medical education for physicians. The AOMA designates this program for a maximum of 38.25 hours of AOA Category 1-A credit and will report CME and specialty credits commensurate with the extent of the physician's participation in this activity. Application has been submitted to the American Academy of Family Physicians for Category 1 prescribed credits. Determination of credits is pending. 

To receive CME credits for the lectures attended, please complete your attestation. Credits will be awarded upon verification of paid registration for the lectures marked as attended. 
 
All credits will be reported to AOA within thirty days of the submission of your attestation form.  Certificates of completion will be emailed to the email address you provide to AOMA. 
 
The items preceded by an asterisk (*) are required entries. All other items are optional. 
 
To confirm your credits for each of the lectures offered, you are required to indicate whether or not you attended each lecture. The evaluation questions are optional, but we greatly appreciate your feedback.
 
Attestation Statement: In accordance with the American Osteopathic Association (AOA) guidelines, this verification of attendance must be on file with the Arizona Osteopathic Medical Association (AOMA) in order to report CME credits to AOA.  *