Required CME Application Documents

Thank you for your interest in having your activity accredited by the Louisiana AAP Institute for Professional Education. Your application is not considered complete until all necessary documents have been submitted. If you have any questions or need assistance, please reach out to Taryn Daigle at taryn.daigle@laaap.org or (337) 945-9209.

Name(Required)

First Last

Email(Required)

Program Name/ Dates(Required)

Attachment 1: The activity topics/content (brochure/program book/announcement/copy of all docs/screenshots advising learners about activity)(Required)

Max. file size: 50 MB.

Attachment 2: The learning objectives (copy of all learning objectives for activity)(Required)

Max. file size: 50 MB.

Attachment 3: The full activity schedule/program/agenda (detailed FINAL agenda/outline showing activity schedule, length of sessions/modules, topic/content 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). Session locations, and/or full online activity access, must be supplied in advance of launch to ensure the 30-minute interval, when applicable, is in place. Sessions/components that are part of the activity but are not designated for CME credits must be clearly labeled and communicated to learners as such. If this information is not evident during review, additional materials must be submitted.(Required)

Max. file size: 50 MB.

Attachment 4: Roster of all individuals involved with planning and reviewing content (planning group/editorial or advisory board/ committee members/COI mitigators/staff, etc)(Required)

Max. file size: 50 MB.

Attachment 5: Roster of all individuals involved with creating and delivering content (presenters/authors/subject matter experts/moderators, etc)(Required)

Max. file size: 50 MB.

Attachment 6: The form, tool, or screenshot used to identify all financial relationships of all individuals in control of content (complete audit reports, and/or disclosure forms, for everyone listed on rosters)(Required)

Max. file size: 50 MB.

Attachment 7: Verification Requirements (required CME/MOC 2 language all learners must receive before starting the activity)(Required)

Max. file size: 50 MB.

Submit attachments 8-12 if your activity received financial support, exhibits, or advertising

Attachment 8: The income and expense statement for this activity that details the receipt and expenditure of all the commercial support (final budget that lists all income and expenses)

Max. file size: 50 MB.

Attachment 9: Each executed commercial support agreement for the activity (all signed letters of agreement, LOAs, and any other financials agreements for all income and/or in-kind support received for the activity)

Max. file size: 50 MB.

Attachment 10: The commercial support disclosure information as provided to learners (copy of how you disclosed all sources of financial/in-kind support to learners before activity started ie grid, verification requirements, etc)

Max. file size: 50 MB.

Attachment 11: Exhibitor Guidelines (copy of instructions, agreements, procedures that outline how exhibits were packaged and sold)

Max. file size: 50 MB.

Attachment 12: Advertisements as shown to learners (copy of documents that housed any ads that were sold for the activity)

Max. file size: 50 MB.

Submit attachments 8-12 if your activity received financial support, exhibits, or advertising

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