CME Activity Application

Instructions: Complete and submit this form in order to request AMA PRA Category 1 Credit™ credit for an upcoming continuing education activity. 
 
Credit: The MetroHealth System is accredited by the Ohio State Medical Association to provide continuing medical education for physicians. The MetroHealth System designates educational activities with AMA PRA Category 1 Credit. Physicians should only claim credit commensurate with the extent of their participation in the activity.
 
Activities certified for AMA PRA Category 1 Credit™, must meet all of the AMA core requirements. Your application will be reviewed by the CME Office and reach out to you within 5-10 days.
 
Questions or concerns?
 
Please contact Steven Ostrolencki at 216-778-1175 or Carrie Henceroth at 216-396-1136.

Please Note: You have the option to save and return to this form by creating an account at the link below. You will be asked to upload and attach the following documents:
 
     •  Complete Program Schedule (Including: dates, times, topics, and speakers.)
     •  Disclosure Form (This must be completed by all activity planners, faculty/presenters,
         and staff participating in this activity.)
     •  Sources of information used to identify practice gap.
     •  If the CME activity will receive commercial support, Written Agreement for Commercial Support [PDF].
    

Save & Return

Optional: Use an account to return to saved work.