Joint Provider Checklist

Below is a checklist of items that will need to be submitted/ collected for review before and after the activity.

You will be responsible for submitting to LIPE

Completed CME application
Planning notes, minutes, etc.
Brochure/program book/announcement/copy of all docs/screenshots advising learners about activity)
Learning objectives from all speakers
Detailed FINAL agenda/outline showing activity schedule, length of sessions/modules, topic/content description of each session/module, and logical sequencing of topics to achieve activity objectives to determine amount of CME credit that will be designated for the activity
Roster of all individuals involved with planning and reviewing content (planning group/editorial board/advisory board/ committee members/COI resolvers/staff, etc)
Roster of all individuals involved with creating and delivering content (faculty/authors/subject matter experts/moderators, etc)
Disclosure forms for ALL individuals in control of content
Evidence that you implemented your mechanism(s) to resolve conflicts of interest for all individuals in control of content prior to the start of the activity (all completed COI forms/audit reports that document how all relationships were resolved
Evaluation Summary
Participant List
Payment for CME Credits
Submit if the activity is an enduring material, internet enduring material, or journal-based CME
The CME product or if online the url & login info (submit archived version of this activity in its entirety as it must be retained for a minimum of 6 years – hard copy, electronic version of activity, screenshots, or pdf)

LIPE will collect from you

You will be responsible for submitting to LIPE