Complete this form to renew a regularly scheduled series such as grand rounds, case review conferences, and tumor boards.
 
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As part of our process improvement plan, the OCPD is requesting information on your continuing education regularly scheduled series.  We would like to learn if you intend to renew or sunset your series (grand rounds, tumor boards, M&M, case review conference, etc). Please provide the following information on the status of your regularly schedule series.
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Official name of the regularly scheduled series (grand rounds, tumor board, M&M, case review conference, etc.)
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Name of the Activity Director
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Name of the primary Continuing Education Coordinator
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Location: (including address, room name/number)
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How would you describe the series to someone who may be interested in participating? What is the educational benefit of attending this series?
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Key Words: (3-5 words)
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Participants who engage in this educational intervention will be able to:
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This series is designed to change: Check all that apply
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Please select the competencies this series is designed to address: Check all that apply
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What platform will you use for your evaluation in 2023? The OCPD offers an easy way to evaluate this series quarterly using EthosCE with survey questions created by OCPD.
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IF the series is accredited for AMA credit only, chose any option. If the series is accredited by the APA, AAPA, or AANP, each session must be evaluated.
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Select Yes or No
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Select Yes or No
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Select Yes or No
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Select Yes or No
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Select Yes or No