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APPLICATION FORMS

All of our application forms are now available in both PDF format and Word format. Viewing the documents in PDF format requires you to have the free Adobe Acrobat Reader installed on your computer. Viewing the documents in Word format requires you to have Microsoft Word or the Word Viewer installed on your computer. If you have questions, please call us at (405) 271-2350, ext. 6.

  • Application Form For A Traditional Conference/Seminar/Symposium (for those seeking CME accreditation for a program including joint sponsorships).Word (updated 03.13.08)

  • Application documents needed as part of the CME application process. Please utilize them as necessary in preparing your application. However, if you still have questions, please call us at (405) 271-2350, ext. 3 or email at Margie-Miller@ouhsc.edu.

    1.   Administrative Fees and Responsibility Designations:
    Jointly Sponsored Fees PDF
    or Directly Sponsored Fees (coming soon) (updated 03.01.08)
    2.   Joint Sponsorship Information HTML

    3.   The ACCME's Essential Elements and Policies HTML

    4.   OU/CME Honorarium Policy PDF / Word
    5.   Summary of the Standards for Commercial Support PDF
    6.   Sample estimated budget for a one-day CME Program PDF/Word (updated 05.01.05)

    7.   Sample Activity Income and Expense Report Form Excel (06.13.07)
    8.   Developing CME Objectives PDF / Word
    9.   Brochure Checklist AND Accreditation Statement PDF / Word  (updated 04.3.08)
    10. Letter of Agreement for Commercial Support PDF / Word (updated 10.19.07)
    11. Speaker Disclosure Form PDF / Word (revised 04.30.08)
    12.
    Sample Speaker Disclosure Slides PDF / Power Point (revised 03.17.06)
    13. Verification of Speaker, Conflict Resolution and Commercial Support Disclosure Form PDF / Word

                               (revised 4.13.05)
    14. Certificate of Attendance PDF / Word (updated 10.19.07)
    15. Evaluations-
    If you plan to develop your own evaluation form, questions #6-#15 on our sample are required questions. See OU/CME's sample evaluation on scantron paper PDF, or in a word document Word
    (updated 6.01.07)

    16. Conflict Resolution Statement  PDF / Word (09.27.07)

  • Application Forms For Regularly Scheduled Conferences(RSC) and Year End Reporting Forms* (for those seeking CME accreditation for a regularly scheduled meeting such as Grand Rounds or Teaching Conferences OR those reporting past accredited program year's end information).
    • Regularly Scheduled Conferences Application Form PDF / Word (updated 10.19.07)

      1.   Application Instruction Letter PDF / Word (updated 05.03.06)
      2.   Developing Objectives PDF / Word
      3.   Essential Elements and Guidelines PDF

      4.   Summary of the Standards for Commercial Support PDF
      5.   Accreditation Statement Instructions for Promotional Materials/Flyers PDF / Word

                     (updated 10.04.07)

      6.   Sample Announcement:

                   Jointly-sponsored conference  Word   (updated 05.18.07)

                   Directly-sponsored conference  Word (updated 05.18.07)

      7.   RSC Fees PDF / Word (updated 02.27.06)
      8.    *RSC Annual Speaker Disclosure Form PDF / Word (updated 04.30.08) New version for 2008-2009
      9.    Conflict Resolution Statement PDF / Word (04.03.08)

      10. *Verification of Speaker, Conflict Resolution and Commercial Support Disclosure Form

                     PDF / Word (revised 8.30.05)

      11. *Annual Survey Word , on scantron paper PDF (updated 06.15.06)
      12. RSC Checklist PDF / Word (updated 4.13.05)
      13. *Sample Reporting Forms PDF / Word (updated 02.27.06)
      14. *Sample Attendance and Evaluation Form
                   Jointly-sponsored conference Word   (updated 10.03.07)

                   Directly-sponsored conference Word (updated 10.03.07)
                   Directly-sponsored conference (multiple speaker sample) Word (updated 06.22.07)
      15. OU/CME Honorarium Policy PDF / Word

      16. FAQ PDF (added 09.14.06)

      17. Criteria for the Outstanding Application and Reporting Documentation Award PDF (added

                      05.04.05)
      18. CME Do's and Don'ts PDF

    • Instructions for OUHSC Departments Paying Application Fee by Transfer PDF / Word
    • Information for Joint Sponsorship Programs (Non-OUHSC Departments) PDF / Word (updated 02.27.06)
    • Forms Required for RSC Programs Receiving Commercial Support includes the following 7 files:

      1. RSC Commercial Support Instruction Letter (New Version Under Construction)

      2. Verification of Speaker, Conflict Resolution and Commercial Support Disclosure Form PDF / Word (revised 4.13.05)

      3. Honorarium Approval Form PDF (added 07.13.06)

      4. RSC Speaker Travel Form PDF / Word (updated 01.04.08)

      5. RSC Letter of Agreement PDF / Word (updated 09.29.06)

      6. "OSF Form 3" PDF (blank form to print and complete) / Online (can be completed online and

             printed for original signature and notarization)

      7a. "Individual Only" (Physicians SSN) Vendor Payee Registration Form PDF OR

      7b. "Company Only" (Company Fed ID#) Paying Vendor Registration Form PDF

  • Application Form For Enduring Materials (for those seeking CME accreditation for an enduring material program). PDF Word (updated 10.19.07)
  • Re-Application Form (for a revision/update of an accredited enduring material program and/or to extend the expiration date) PDF / Word (updated 2.27.06)
University of Oklahoma Health Sciences Center (OUHSC) / Irwin H. Brown Office of Continuing Medical Education
Toll Free: 1-888-OUCME4U (682-6348)
Local: (405) 271-2350
Fax: (405) 271-3087
E-mail: cme@ouhsc.edu
General Mail (not packages)
P.O. Box 26901, ROB 202
Oklahoma City, OK 73190
Packages Only
800 N.E. 15th Street, Room 202
Oklahoma City, OK 73104

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