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MSS Fall Conference
Evaluation Form
AMERICAN COLLEGE OF SURGEONS
Division of Education
Minnesota Surgical Society
American College of Surgeons Chapter
2023 Fall Conference
September 29-30, 2023
Rochester, MN
*
1.
Name
(Required.)
*
2.
Credentials
(Required.)
MD, FACS
MD
DO, FACS
DO
Other (please specify)
*
3.
Email Address
(Required.)
*
4.
Are you a member of the American College of Surgeons?
(Required.)
YES
NO
5.
ACS Membership ID (credits will not post to your ACS MyCME webpage if ID not provided)
*
6.
State(s) you are licensed?
(Required.)
*
7.
Choose One
(Required.)
Active Member
Associate Member
Resident
Medical Student
Research Trainee
Retired
Non-Member
8.
Number of years in practice (optional)
9.
Specialty (optional)
