CME Applications and Forms
If you are interested in utilizing AOA CME, please click here.One-Time/Single Activity OR New Regularly Scheduled Series
Application must be submitted at least 60 days prior to the event.
If an application from an organization external to Kettering Health is approved, there will
be a KH CME Certification Fee required by planners of the event. Fee is determined by KH CME depending upon several
factors. Notification will be made upon approval.Regularly Scheduled Series (RSS) (e.g., cancer conferences, M&M series, etc.)
Planning Packet & Forms
- CME Event Design (opens in new tab)
- Best Practices for Creating Objectives (opens in new tab)
- Timeline for Planning CME Events
- Speaker/Presenter Initial Letter (Sample) (opens in new tab)
- KH Exhibitor Agreement (opens in new tab)
- Financial Relationships (COI) Form
- CME Event Review by Planner (opens in new tab)
- CME Disclosure & Registration Instructions (display at event) (opens in new tab)
- Generic Sign-In Sheets MS Word (opens in new tab) | MS Excel (opens in new tab)
- Speaker/Presenter CME Claim Form (opens in new tab)
- Liaison Event Checklist (opens in new tab)
Miscellaneous Information
Contacts:
Kim Kremer, MS
CME Coordinator
937-232-2476
Martin Jacobs, MD
CME Chair
937-395-8611