Arizona Osteopathic Medical Association 96th Annual Convention

ATTESTATION AND EVALUATION FORM

IMPORTANT INSTRUCTIONS BELOW

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THIS FORM IS UNIQUE TO THE 2018 CONVENTION ATTESTATION. YOUR USER NAME AND PASSWORD FROM THE AOMA WEBSITE OR PAST CONVENTIONS IS NOT VALID. PLEASE CREATE A NEW USER PROFILE.

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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.  For DOs, your AOA number is required to complete the form.  

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Acccreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Touro University Nevada College of Osteopathic Medicine (TUNCOM) and the Arizona Osteopathic Medical Association.
 
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.
 
TUNCOM is accredited by ACCME to provide continuing medical education for physicians. TUNCOM designates this live activity for a maximum of 38.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
 
This Live activity, Arizona Osteopathic Medical Association 96th Annual Convention - Shifting the Paradigm, with a beginning date of 04/11/2018, has been reviewed and is acceptable for up to 35.75 Prescribed credit(s) by the American Academy of Family Physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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) and the Accreditation Council for Continuing Medical Education (ACCME) guidelines, this verification of attendance must be on file with the Arizona Osteopathic Medical Association (AOMA) in order to report CME credits to AOA.  *
Type of Credit Requested: Please indicate the type of CME credit your are requesting: AOA Category 1-A or AMA PRA Category 1. 

NOTE: Only one type of CME credit will be awarded. 
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