On-Line Accreditation Form

All data must be in English Language only ( don't use autofill from your browser )

Documents must be ready before you start proceed your Accreditation Request
-Upload CME Activity Topics ( PDF, image, Microsoft office formatting are accepted )
-CME Activity Speakers resume ( PDF, image, Microsoft office formatting are accepted )

Provider

Provider Name*

Provider Type *

Provider Phone*

Alternative Phone Number*

Provider Address

Address*

Country*

City *

Zip Code

Provider website

Contact Person

Contact Person Title*

Contact Person Name*

Contact Person Phone*

Email ( For receive accreditation processes Emails )*

CME activity

Cme Activity Title*

Cme Activity Type *

Professions *

Specialization *

Other Professions

Other Specialization

Cme Activity OutPut Purpose

Handout material (EACMED has the right to request a soft copy or hard copy of CME activity material)
Hard Copy Soft Copy

Start Date *

End Date *

Duration ( Active Days ) *

CME Activity Includes Hand on training or practical Activities ( Training activity on patient are prohibited ) *

CME Activity Location

Address*

Country*

City

Zip Code

Room Facilities

Audio equipment

video equipment

E-learning equipment

Coffee Break

Expectation of Attendees Number

Scientific Committee

CME Activity Director Title *

Director First name *

Director middle name *

Director Family name *

CME Activity Speakers resume ( PDF, image, Microsoft office formatting are accepted ) *

Upload CME Activity Topics ( PDF, image, Microsoft office formatting are accepted ) *

Funding

Funding Type *

Sponsor Name ( sponsor 1 , sponsor 2 , .......)

Accreditation process - Accreditation Acceptance may take from 4 to 10 working days. - Provider should deliver the Accreditation fees within 4 working days after receiving the Approving letter or Email - The CME Provider will receive Accreditation Certificate within 2 workinfg days After Accreditation fees Collection - EACMED Audit Team will be attended the CME Activity

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