LAW ENFORCEMENT OFFICERS WILL KEEP THIS PORTION FOR THEIR RECORDS University of Arkansas for Medical Sciences Office of Continuing Education Certifies that ___________________________
Trang 1LAW ENFORCEMENT OFFICERS WILL KEEP THIS PORTION FOR THEIR RECORDS
University of Arkansas for Medical Sciences
Office of Continuing Education
Certifies that _
participated in the live activity entitled ICARE: Improving Critical and Acute Care through Regional Education
May 3-5, 2017 The Chancellor Hotel, Fayetteville, AR
This live activity was designated for a maximum of 15.00 AMA PRA Category 1 Credits™
I participated in hours
(Please fill in the # of credits you are claiming from the Credit Claim Form for Attestation of Participation.)
CoCO- Director, UAMS Office of Continuing Education
The University of Arkansas for Medical Sciences Office of Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians
A transcript of all participation in UAMS accredited CE activities, is available from the Office of Continuing Education website 24/7 To obtain a transcript go to ce.uams.edu Transcripts for this activity will be available
6-8 weeks after the activity
Please direct questions to:
UAMS Office of Continuing Education, 4301 W Markham #525, Little Rock, AR 72205
LAW ENFORCEMENT OFFICER Certificate
Trang 2In order to receive CME credit, this page MUST be filled out completely, and
returned to the Registration Desk or UAMS CE Office
CREDIT CLAIM FORM FOR ATTESTATION OF PARTICIPATION
Please fill in the hours that you are claiming in the ‘# Credits Attended column’, indicate Total Credits
Claimed, and sign the attestation below
ICARE: Improving Critical and Acute Care Through Regional Education
May 3-5, 2017 The Chancellor Hotel, Fayetteville, AR
TIME FRAME SESSION NAME AVAILABLE CREDITS ATTENDED # CREDITS
May 3 rd 0900 – 1100 Active Shooter Response Tabletop Exercise 2.00
1445 – 1545 Group Reports: Future Directions for Statewide Efforts, Debriefing of Active Shooter Tabletop Exercise 1.00
0830 – 0930 Rapid Fire Didactics – Session 1 1.00
0930 – 1000 Q&A Panel on Rapid Fire Didactics – Session 1 0.50
1030 – 1130 Rapid Fire Didactics – Session 2 1.00
1130 – 1200 Q&A Panel on Rapid Fire Didactics – Session 2 0.50
1615 – 1715 Summation of Breakouts and Wrap-Up 1.00
May 5 th 0800 – 0845 Reflections on Current Work and Looking Ahead 0.75
Day 1 = 4.50 Day 2 = 7.00 Day 3 = 3.50 TOTAL=15.00
(Remember to enter credits claimed on first page of this form.) TOTAL CREDITS CLAIMED
Last 4 of SSN xxx-xx- Cell Phone # - - (for identification purposes only)
Law Enforcement Officer Other:
LEGIBLY PRINTED Name _
Affiliation
Mailing Address _
City/State _Zipcode _
I attest that I attended the hours indicated above
Signature