CPL Event Registration Form

The University of New Mexico School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The University of New Mexico School of Medicine designates this live activity for a maximum of 2.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.


Thank you for your interest in this CPL offering. This form has two parts.


Part One requests demographic information and describes any registration fees and payment associated with this event. This page must be completed in order for your registration to be confirmed.


Part Two is optional and requests information which assists CPL in better understanding the reasons for your interest, and in evaluating our program offerings and marketing methods for improvement.


Please answer all questions and click the "Submit" button at the end of the form to ensure a complete registration. Review CPL's General Workshop Requirements here: https://bit.ly/CPLWorkshopRequirements

 

Learning in small Groups:How to Make it Work (Blended)

Date: Wednesday, September 6, 2023


Time: 1:00 -3:00 pm


Registration Deadline: August 16, 2023


Registration Fee:


UNM/HSC Employee: $175


Non-UNM/HSC Employee: $195

 

Blended opportunities include online, self-paced learning completed before a live, in-person session.

 

As you would like it to appear on your attendance certificate:

 

As you would like it to appear on your attendance certificate:

 

As you would like it to appear on your name badge:

 
 

The category that best describes my Position Title is:

 
 

Please add your department (example: Internal Medicine, Pediatrics, etc.). If you are not affiliated with UNM/HSC please write "None."

 

(If a UNM/HSC employee, please provide your @Salud or @ UNM address):

 
Phone