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311217 - Attestation Form: 19th Annual Tumors of the Central Nervous System

2.Attendance Verification

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 below questions in order to receive your CME certificate. Your certificate will be emailed to you within the next 2-3 weeks.

* Questions with an asterisk are required before form 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 (4.0 CME hrs)
Monday - afternoon session (3.0 CME hrs)
Tuesday - morning session (4.0 CME hrs)
Tuesday - afternoon session (4.0 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 15.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

How many credits will you be claiming?

*THIS QUESTION REQUIRES AN ANSWER

(Required.)