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Forms & Documents

Whether you're a local healthcare provider looking to design a CME event or program for your staff or an agency hoping to educate a broad spectrum of clinicians about an issue in your community, we can help.

Primary Documents

  1. CME Request Form / CME Request Form
  2. UND CME Conflict of Interest Resolution Process
  3. Sample Timeline
  4. Sample Flyer
  5. Gap Analysis/Needs Assessment Form
  6. Sample Evaluation
  7. Sample Pre-Budget
  8. Planning Process Documentation
  9. Conflict of Interest Disclosure form ALL
  10. UND SMHS Providing Unit COI Disclosure Form 2023
  11. Joint Providership Agreement
  12. Sample CV
  13. Documentation Disclosure Occurred
  14. Sample Final Budget
  15. Sample Evaluation Summary
  16. Roster Sheet

Additional Documents

  • Accreditation Designation Statement
  • Content Validity
  • CME Documentation Checklist
  • Eligibility Criteria
  • Fee Schedule (contact us for details)
  • Objectives Request Form
  • Verbs
  • Presenter Letter
  • Worksheet CME Evaluation
  • Learner Gap Analysis Document
  • ACGME General Competencies
  • Institute of Medicine Core Competencies

DISCLAIMER: It is the program's responsibility to verify that these forms are current. Please contact the OCMEO before proceeding with an activity.

Continuing Medical Education Office
SMHS Room E458
1301 N. Columbia Road
Grand Forks, ND  58202-9037
P 701.777.3201

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School of Medicine & Health Sciences

1301 N Columbia Rd Stop 9037
Grand Forks, ND 58202-9037

701.777.2514

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