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311135 Attestation Form: Neuroradiology Clinical Functional MRI Spectroscopy, Head & Neck Radiology

2.Attendance Verification Form

The AMA requires that the number of credits listed on CME certificates be based on the actual credit claimed by each physician. Please complete the questions below in order to receive your CME certificate. Your certificate will be emailed to you 2-3 weeks after the survey is completed.

* Questions with an asterisk are required before evaluation can be submitted.

Thank you.
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1.YOUR NAME FOR CERTIFICATE: Please type your name how you would like it to appear on your certificate.
*THIS QUESTION REQUIRES AN ANSWER(Required.)
2.Your Degree
*THIS QUESTION REQUIRES AN ANSWER(Required.)
3.Your Email address for Certificate:
*THIS QUESTION REQUIRES AN ANSWER(Required.)
4.Did you attend the entire course?(Required.)
5.Please indicate which sessions you attended
Attended
Did Not Attend
Monday morning session (4 CME hrs)
Monday afternoon session (4.25 CME hrs)
Tuesday morning session (4.75 CME hrs)
Tuesday afternoon session (4 CME hrs)
Wednesday morning session (4.25 CME hrs)
Wednesday afternoon session (3.75 CME hrs)
Thursday morning session (4.25 CME hrs)
Thursday Afternoon session (3.5 CME hrs)
Friday morning session (4.25 CME hrs)
Friday morning session (3.5 CME hrs)
6.

ACCREDITATION

The Harvard Medical School is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The Harvard Medical School designates this live activity for a maximum of 40.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Combined Activities: A maximum of 40.5 AMA PRA Category 1 Credits™
Neuroradiology Only: A maximum of 29.5 AMA PRA Category 1 Credits™
Head and Neck Radiology Only: Core Course Only: A maximum of 15.5 AMA PRA Category 1 Credits™

How many credits will you be claiming?

*THIS QUESTION REQUIRES AN ANSWER

(Required.)