LA-ACS Chapter ACS Annual Meeting

CME Evaluation Form

AMERICAN COLLEGE OF SURGEONS

Division of Education

Louisiana Chapter

American College of Surgeons

2024 Annual Meeting

April 5-7, 2024

New Orleans, LA

Question Title

* Name

Question Title

* Choose One

MD, FACS

MD

DO

Other (please specify)

Question Title

* Email Address

Question Title

* Are you a member of the American College of Surgeons?

YES

NO

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* ACS Membership ID (credits will not post to your ACS MyCME webpage if ID not provided)

Question Title

* Choose One

Active Member

Associate Member

Resident

Medical Student

Research Trainee

Retired

Non-Member

Question Title

* Number of years in practice (optional)

Question Title

* Specialty (optional)