1. Attendance Verification - Last Page

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The 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. You will need to fill out the below questions in order to receive your certificate. Your certificate will be emailed to you approximately three weeks after the survey is completed.

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* 1. Please print your name for the certificate:

*THIS QUESTION REQUIRES AN ANSWER

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* 2. Your Degree:

*THIS QUESTION REQUIRES AN ANSWER

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* 3. Email Address for your certificate:

*THIS QUESTION REQUIRES AN ANSWER

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* 4. Did you attend the entire course? *THIS QUESTION REQUIRES AN ANSWER

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* 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)

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* 6. This activity is designated for a maximum of 14 AMA PRA Category 1 Credits and other Continuing Education Credits. How many credit hours will you be claiming?

*THIS QUESTION REQUIRES AN ANSWER

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