Skip to content

311326 Attestation Form: Treating Couples

4.Attendance Verification Form

Harvard Medical School, AMA and Cambridge Health Alliance requires that the number of credits listed on 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 2-3 weeks after the survey is completed.

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

Thank you.
1 / 1
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.)
5.Please indicate which sessions you attended
Attended
Did Not Attend
Friday Morning Session (4 hrs)
Friday Afternoon Session (3 hrs)
Saturday Morning Session (4 hrs)
Saturday Afternoon Session (3 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 14 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

All non-MD participants must also submit hours of participation in order to obtain certificate of attendance.

How many credits will you be claiming?

*THIS QUESTION REQUIRES AN ANSWER

(Required.)