PROCEDURE - APPLICATION
Application Single Occurrence & Recurring Activities:
•  submit 60 days prior to the date of the planned activity

Joint Sponsorship Single Occurrence & Recurring Activities:
•  submit 90 days prior to the date of the planned activity

Responsible Physician
•  sign application Planning Committee
•  list names & titles
•  must include physician responsible for activity
•  may not include representative from commercial supporting companies

Target Audience
•  identify physician specialties & non-physician groups

Needs Assessment
•  identify how education need was determined (e.g. written or phone survey)

Learning Objectives Single Occurrence Activity:
•  state what the participant should be expected to know or do at the end of activity
•  state applicable pre-requisites

Recurring Activity
•  state what the participant should be expected to know or do at the end of activity
•  specific objectives must be provided for each session as they occur
•  state applicable pre-requisites

Teaching Methods
•  list methods (e.g. lecture, workshop)

Promotional Materials
•  submit draft of all promotional materials with application
•  print & distribute promotional material after CME Committee approval of activity - do not reference CME on promotional material prior to approval (e.g. CME credit applied for, CME pending, etc.)
•  include the following accreditation state as printed:

For GRMERC sponsored activities
"The Grand Rapids Medical Education & Research Center for Health Professions is accredited by the Michigan State Medical Society Committee on CME Accreditation to provide continuing medical education for physicians. The Grand Rapids Medical Education & Research Center for Health Professions designates this educational activity for a maximum of [number of credits] Category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity."

For joint sponsored activities
"This activity has been planned and implemented in accordance with the Essential Areas and policies of the Michigan State Medical Society Committee on CME Accreditation through the joint sponsorship of the Grand Rapids Medical Education & Research Center for Health Professions and (name of non-accredited provider). The Grand Rapids Medical Education & Research Center for Health Professions is accredited by the Michigan State Medical Society Committee on CME Accreditation to provide continuing medical education for physicians. The Grand Rapids Medical Education & Research Center for Health Professions designates this educational activity for a maximum of [number of credits] Category 1 credits toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity."

Application Attachments
•  include attachments applicable to the activity:

• Planning Committee disclosure from each Planning Committee Member
• Curriculum Vitae for each speaker
• Speaker Disclosure - for each speaker
• Speaker Information-for each speaker
• Draft Budget - identify any income and/or expenses of the activity
• Commercial Support Information form for each commercial support company
• Agenda (Please note only the lecture and the question and answer portion of the activity are counted toward CME credit)
• Draft brochure using the correct accreditation statement. Please not you must not include any reference to CME credit on your pre-publicity materials (e.g. save the date).

If you have any questions in completing the application, please call the GRMERC CME office at 616-732-6246.

Procedure - Attendance Sheet & Evaluation Form
Attendance, evaluation and record keeping are basic components of the CME process.

Attendance Sheet & Evaluation Forms
•  All physician participants must sign the attendance sheet AND legibly complete an evaluation form to receive Category 1 credit.
•  All other participants are encouraged to sign the attendance sheet and complete an evaluation form.

Evaluation Form asks the participants to:
•  evaluate the activity
•  identify if learning objectives were met
•  identify if speaker disclosure was announced
•  identify if education grant support was announced
•  identify suggested topics for future activities

Responsibilities of activity planner, or designee:
•  obtain attendance sheet & evaluation forms prior to activity
•  make attendance sheet & evaluation forms available to activity participants
•  collect attendance sheet & evaluation forms at the end of the activity
•  return attendance sheet & evaluation forms to the MERC CME office with 48 hours of the activity

NOTE: It is the individual physician's responsibility to legibly complete the evaluation form at the time of the activity. Completed evaluation forms must be returned as a group with the completed attendance sheet, individual evaluation forms will not be accepted.