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3224460 - Attestation Form: Practical Head and Neck Pathology

2. Attendance Verification - Final Page

Thank you for completing our attestation form. If you have submitted the attestation form at least 60 days after the seminar has ended please contact HMS/DCE at:
hmscme_evaluations@hms.harvard.edu to inform us that you have submitted your hours for credit.

Thank you for your participation and we look forward to welcoming you to another HMS/DCE offering.


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1.YOUR NAME FOR CERTIFICATE: Please type your name how you would like it to appear on your certificate.
*THIS QUESTION REQUIRES AN ANSWER(Required.)
2.Your Degree
*THIS QUESTION REQUIRES AN ANSWER(Required.)
3.Your Email address for Certificate:
*THIS QUESTION REQUIRES AN ANSWER(Required.)
4.Did you attend the entire course?(Required.)
5.Please indicate which sessions you attended
Attended
Did Not Attend
Friday - morning sessions (3.75 CME hrs)
Friday - afternoon sessions (3.50 CME hrs)
Saturday - morning sessions (4.50 CME hrs)
Saturday - afternoon sessions (3.75 CME hrs)
Sunday- morning sessions (3.75 CME hrs)
Sunday - afternoon sessions (3.50 CME 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 22.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

How many credits will you be claiming?

*THIS QUESTION REQUIRES AN ANSWER

(Required.)