Continuing Education Application Form

Continuing Education Application Form

This form is for anyone interested in hosting a continuing education course through Boston Children's Hospital Department of Education. Please fill out each section to the best of your ability. If you have any questions, please reach out to cmedepartment@childrens.harvard.edu.

Submission Date*

Course Title*

Course Start Date*

Calendar Year*

Select or enter value

Sponsoring Department*

Select

Course Type*

Select or enter value

Primary Course Director*

Course Director Email*

Course Coordinator*

Course Format*

Select or enter value

Credit Type Requested*

Select or enter value

RSS Total Credit Hours Awarded*

# of Credit Hours*

Is this course a renewal of a previously approved Boston Children's Hospital accredited course?

Select

Will this course target an interprofessional audience?

Will you be requesting marketing services? (Additional fees apply)

Will you be requesting technical assistance (Additional fees apply)

Are you interested in making this an enduring material? (Additional fees may apply)

Documents Upload

Please upload your completed application and course agenda and any other documents supporting this course here.

Drag and drop files here or

Before submitting this form, please be sure you have uploaded the following items:

Completed Application*

Course Agenda*

By checking this box, you are attesting that the content of this activity meets the requirements of the Standards for Integrity and Independence in Accredited Continuing Education*

*This attestation indicates that you have read, understand and will comply with the standards provided below

Link: Standards for Integrity and Independence

Link: Standard 1

Link: Standard 2

Link: Standard 3

Link: Standard 4

Link: Standard 5

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