certificate of participation · please keep this copy for your records. the academy does not...

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Please keep this copy for your records. The Academy does not require a copy. 345 Park Blvd | Itasca, IL 60143 | 800/433-9016 | 847/434-8000 (fax) The American Academy of Pediatrics certifies that Name (First/MI/Last/Degree) has participated in the live activity titled 2018 National Conference & Exhibition in Orlando, FL on November 2-6, 2018, ACCME PARS ID 201123100 and is awarded ____ AMA PRA Category 1 Credit(s)™. The American Academy of Pediatrics (AAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The AAP designates this live activity for a maximum of 47.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is acceptable for a maximum of 47.50 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the AAP. This Live activity, 2018 AAP National Conference & Exhibition, with a beginning date of 11/02/2018, has been reviewed and is acceptable for up to 25.00 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. Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 15 MOC Part 2 points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit. Please note: your completion data will be shared with the ABP through the ACCME PARS system within 30 days of successful completion. This will include the name of the activity and provider; participant name; participant’s ABP ID number; participant’s DOB; date of completion of the activity; the PARS activity identifier; ABP MOC Part 2 credit statement and number of MOC points awarded. If any questions or concerns please contact the activity manager at [email protected]. Fill in your total credits to the right. Be sure to sign this form when completed as verification of the credits you recorded. Please keep this copy for your records. The Academy does not require a copy. Mailing Address: _____________________________________ City/State/Zip/Country: ________________________________ Email: _____________________________________________ Signature: __________________________________________ Certificate of Participation Physician Continuing Medical Education Credit Breakdown Total Credits: ___________ (max. 47.50) Total MOC 2: ___________ (max. 15)

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Page 1: Certificate of Participation · Please keep this copy for your records. The Academy does not require a copy. 345 Park Blvd | Itasca, IL 60143 | 800/433-9016 | 847/434-8000 (fax)

Please keep this copy for your records. The Academy does not require a copy.

345 Park Blvd | Itasca, IL 60143 | 800/433-9016 | 847/434-8000 (fax)

The American Academy of Pediatrics certifies that

Name (First/MI/Last/Degree)

has participated in the live activity titled 2018 National Conference & Exhibition in Orlando, FL on November 2-6, 2018, ACCME PARS ID 201123100 and is awarded ____ AMA PRA Category 1 Credit(s)™. The American Academy of Pediatrics (AAP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The AAP designates this live activity for a maximum of 47.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. This activity is acceptable for a maximum of 47.50 AAP credits. These credits can be applied toward the AAP CME/CPD Award available to Fellows and Candidate Members of the AAP. This Live activity, 2018 AAP National Conference & Exhibition, with a beginning date of 11/02/2018, has been reviewed and is acceptable for up to 25.00 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. Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 15 MOC Part 2 points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.

Please note: your completion data will be shared with the ABP through the ACCME PARS system within 30 days of successful completion. This will include the name of the activity and provider; participant name; participant’s ABP ID number; participant’s DOB; date of completion of the activity; the PARS activity identifier; ABP MOC Part 2 credit statement and number of MOC points awarded. If any questions or concerns please contact the activity manager at [email protected].

• Fill in your total credits to the right.

• Be sure to sign this form when completed as verification of the credits you recorded.

• Please keep this copy for your records. The Academy does not require a copy.

Mailing Address: _____________________________________ City/State/Zip/Country: ________________________________ Email: _____________________________________________ Signature: __________________________________________

Certificate of Participation Physician Continuing Medical Education

Credit Breakdown

Total Credits: ___________ (max. 47.50)

Total MOC 2: ___________ (max. 15)