At the time of recertification, complete this form. You will need to upload proof of at least 12 ringside medicine CME at the bottom of this form.

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* 1. ACSM ID Number

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* 2. Certificate Number

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* 3. First Name

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* 4. Last Name

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* 5. Degree (MD, DO, or Foreign Equivalent)

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* 6. Contact Information

Required number of accredited “ringside medicine” CME in a 3-year cycle is 12 credits.

Accredited “ringside medicine” CME includes but is not limited to the Association of Ringside Physicians Annual Conference.

Use the fields below to upload documentation. If more is needed please contact mjohns@reesgroupinc.com.

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* 7. CME Documentation 1

DOCX, DOC, JPEG, JPG, PDF, PNG file types only.
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* 8. CME Documentation 2

DOCX, DOC, JPEG, JPG, PDF, PNG file types only.
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* 9. CME Documentation 3

DOCX, DOC, JPEG, JPG, PDF, PNG file types only.
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* 10. CME Documentation 4

DOCX, DOC, JPEG, JPG, PDF, PNG file types only.
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