Forms and Templates
Overview
All entities applying to ACEP for the consideration of AMA PRA Category 1 CreditTM are REQUIRED to successfully complete the ACEP CME Training Course. Completion of the course includes reviewing all information on this page as well as corresponding links, utilizing all required templates, and adhering to all ACEP, AMA, and ACCME guidelines, policies, and procedures. Non-compliance will result in ACEP being unable to award credit for the activity and/or the revocation of credit regardless of whether an activity has already been promoted with credit approval.
General Information
CME Governing Bodies
ACEP CME Mission Statement
ACEP Accreditation Fees Quick Reference Document
ACEP Honoraria Policy
ACEP Communication Process Quick Reference Document
Designating and Awarding Credit Quick Reference Document
Accreditation & Designation Statements
Online Disclosure Form Instructions
ACEP Process for Resolving Conflict of Interest Quick Reference Document
Timelines & Deadlines
Trello Board Management Quick Reference Document
ACEP Membership Mailing List Rental Information
Marketing & Promotion
Marketing & Promotion Quick Reference Document
Activity Planning
Gap Analysis Quick Reference Document
Gap Analysis Worksheet
Verbs for Writing Learning Objectives
Clinical Content & Validation Quick Reference Document
Required Template - Planning CCRV Form
Required Template - Pre-Activity CCRV Form
Required Template - On-Site CCRV Form
Desirable Physician Attributes Quick Reference Document
Format-Specific Requirements Quick Reference Document
Disclosure to Learners and Front Matter
Disclosure to Learners Quick Reference Document
Required Template - Live Activity Disclosure to Learners
Required Template - Enduring Materials Front Matter (Hosted in ACEP OLC)
Required Template - Enduring Materials Front Matter (Not Hosted in ACEP OLC)
ACEP Process for Verbal Disclosures from the Podium Quick Reference Document
Required Template - Verbal Disclosure from the Podium
CME Certificates
CME Certificate Quick Reference Document
Certificate Delivery Options via ACEP CME Tracker Quick Reference Document
Required Template - ACEP CME Tracker Customer Data Upload Template
Required Template - Live Activity (Physician - Direct ACEP Only)
Required Template - Live Activity (Physician - Single Joint Provider)
Required Template - Live Activity (Physician - Multiple Joint Providers)
Required Template - Enduring Material (Physician - Direct ACEP Only)
Required Template - Enduring Material (Physician - Single Joint Provider)
Required Template - Enduring Material (Physician - Multiple Joint Providers)
Required Template - Manuscript Review (Physician - Direct ACEP Only)
Required Template - Manuscript Review (Physician - Single Joint Provider)
Required Template - Manuscript Review (Physician - Multiple Joint Providers)
Required Template - Journal-based CME (Physician - Direct ACEP Only)
Required Template - Journal-based CME (Physician - Single Joint Provider)
Required Template - Journal-based CME (Physician - Multiple Joint Providers)
Required Template - Performance Improvement (PI) CME (Physician - Direct ACEP Only)
Required Template - Performance Improvement (PI) CME (Physician - Single Joint Provider)
Required Template - Performance Improvement (PI) CME (Physician - Multiple Joint Providers)
Required Template - Other-Virtual Blended Conference (Physician - Direct ACEP Only)
Required Template - Other-Virtual Blended Conference (Physician - Single Joint Provider)
Required Template - Other-Virtual Blended Conference (Physician - Multiple Joint Providers)
Required Template - Live Activity (Non-Physician)
Required Template - Enduring Material (Non-Physician)
Activity Evaluation
Activity Evaluation Quick Reference Document
Required Template - Clinical Content
Required Template - Non-clinical Content
Agreements - Individuals in Control of Content
Agreements for Individuals in Control of Content Quick Reference Document
Commercial Support
Commercial Support Quick Reference Document
Required Template - Letter of Agreement for Commercial Support (LOA)
Outcomes Measurement
Outcomes Measurement Quick Reference Document
Required Template - Skills Checklist Summary
Required Template - Skill Checklist Individual Participant
Post-Activity Requirements
Quick Reference Document
Participant List Quick Reference Document
Reconciled Income and Expense Statement Quick Reference Document
Monthly CME Newsletters
March 2021
Last updated July 5, 2021
