USA College of Medicine
 
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Contact Us

USA College of Medicine
Continuing Medical Education

251 CSAB
Mobile, Alabama 36688
Phone: (251) 414-8080
Fax: (251) 414-8081

M. Margaret O'Brien, J.D., M.D.

Associate Dean, Student Affairs
Email: mobrien@usouthal.edu

Sharrie Cranford, LGSW
Director, Continuing
Medical Education
Email: scranford@usouthal.edu

Yolanda Mack
Word Processing Specialist
Email: ymack@usouthal.edu

 
     
 

Continuing Medical Education

Forms and Documents

 
You must have Adobe Acrobat to view these forms (with the exception of "Objective/Syllabus Form" and "Letter of Agreement..." which are in .WPD format). If you do not have Acrobat Reader, you may download a free copy. If you would prefer to have a copy in Microsoft Word, please contact Sharrie Cranford, in the Department of CME.
 
Downloadable Forms that you will need only after your activity has been approved:
 
Letter of Agreement Regarding Terms, Conditions, and Purposes of an Educational Grant
Disclosure Statement for On-Going Activity - Speaker
Disclosure Statement for On-Going Activity - Director
Disclosure Statement for On-Going Activity - Planning Committee
Disclosure Statement for Special Activity - Speaker
Disclosure Statement for Special Activity - Director
Disclosure Statement for Special Activity - Planning Committee
Speaker Information Form
Objective/Syllabus Form
Attendance Sheet for Ongoing Activities
Attendance Sheet for Special Activities
Conflict of Interest Review Form
 
Important Documents

USA Policy and Procedures for Commercial Support for Ongoing and Unique CME Programs

 
Evaluations
 
 
 
         
 
   
 


University of South Alabama
- Mobile Alabama 36688-0002 (251) 414-8080
For questions or comments Contact Us
Date last changed: July 10, 2008 5:17 PM
http://www.southalabama.edu/com/cme/forms.shtml


 
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