322466 - Attestation Form: School Mental Health

9.Attendance Verification

Harvard Medical School and Cambridge Health Alliance requires that the number of credits listed on CME certificates be based on the actual credit claimed by each attendee. Please complete the questions below in order to receive your CME certificate. Your certificate will be emailed to you with the next 2-3 weeks.

Thank you and if you have any questions, please let us know.

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*1.Please print your name for the certificate: *THIS QUESTION REQUIRES AN ANSWER(Required.)

*2.Your Degree: *THIS QUESTION REQUIRES AN ANSWER(Required.)

*3.Email Address for your certificate:
*THIS QUESTION REQUIRES AN ANSWER(Required.)

*4.Did you attend the entire course? *THIS QUESTION REQUIRES AN ANSWER(Required.)

Yes (If yes, scroll down to the bottom of the page and submit your Continuing Education hours)

No (If no, please indicate which sessions you attended)

5.Please indicate which sessions you attended

Attended

Did Not Attend

Friday Morning Session (4 hrs)

Attended

Did Not Attend

Friday Afternoon Session (3 hrs)

Attended

Did Not Attend

Saturday Morning Session (4 hrs)

Attended

Did Not Attend

Saturday Afternoon Session (3 hrs)

Attended

Did Not Attend

*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 14 AMA PRA Category 1 Credits™. Cambridge Health Alliance is approved by several continuing education organizations.

Attendees can only claim credits for the amount of hours spent at the course.

How many hours are you claiming?

(Required.)

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