Meeting Accreditation Application Form

This field is hidden when viewing the form

Logged In User ID

General Information

Name of Event(Required)

Location(Required)

Sponsoring Organization(Required)

Start Date(Required)

End Date(Required)

Person Requesting Approval

Title

First Name(Required)

Last Name(Required)

Business Address(Required)

Street Address Address Line 2 City Province / State Postal Code / ZIP Country

Telephone(Required)

Email(Required)

Important Note: In order to receive emails when the "Speaker Information Form" is submitted, you must specify your email here, before clicking "Save Progress for Later"

Committee Information

At least one member of the committee must be a Fellow in good standing with the CACB, OCQ, or other medically qualified group who will be integrally involved in the planning process to ensure that the context and process for the meeting will meet CSCC/CACB Professional Development guidelines.

Committee Fellow - Title

Committee Fellow - First Name(Required)

Committee Fellow - Last Name(Required)

List All Members of the Organizing Committee with their Current Position and Institution(Required)

Each Member of the Committee Must Submit a Signed Conflict of Interest Form(Required)

Download COI Form

Drop files here or

Max. file size: 30 MB.

Needs Assessment

Whenever content is discussed and developed for an event or session, it is essential to determine who the target audience is, and their educational needs.

1. Target Audience(Required)

Clinical or medical biochemist

General pathologist

Other physician

Medical laboratory technologist

Laboratory manager

Other healthcare professional

(check all that apply)

Target Audience "Other"(Required)

2. Purpose and Overall Goal(s)(Required)

3. Needs Assessment

Resources:

Planning Committee members
Surveys and questionnaires
Self-assessment tests
Quality assurance data from hospitals, regions
Provincial databases
Incident reports
Published literature
Requests for future topics from past evaluation forms
Other

3.1. Attach Minutes or Other Documentation (surveys, etc.) of Planning Meetings Where Review of Needs and Selection of Topics Took Place(Required)

Drop files here or

Max. file size: 30 MB.

3.2. Enter a Summary Statement Outlining Why the Major Topics Have Been Selected and How the Topics Meet the Gap Between Current Knowledge and Desired Knowledge/Solutions(Required)

Learning Objectives

1. General Objectives for Each Symposium, Workshop, or Roundtable Must Be Established.

Do the Learning Objectives Describe What the Participant May Learn or Achieve by Attending the Session? Attach a Copy (below) of the Program/Agenda Showing the Learning Objectives for Each Presentation:(Required)

Drop files here or

Max. file size: 30 MB.

2. Indicate How the Learning Objectives Will Be Communicated to the Audience PRIOR to the Conference(Required)

Preliminary program

Final program

Handout materials

Other

(check all that apply)

Other (Learning Objective Communication)(Required)

(describe briefly)

3. Will the Speakers Be Provided With, and Complete the Following CE-approved Forms?(Required)

Letter of request with general learning objectives for the session Download Sample Letter to a Speaker

List of Verbs For Formulating Educational Objectives Download Verbs Document

Online Speaker Information Form (all speakers must complete a signed form - send Speaker Form URL below)

(check all that apply)

Speaker Information Form

The below URL to the "Speaker Information Form" can be sent to each Speaker and will allow them to submit the required information to THIS Meeting Accreditation submission (be sure to SAVE your progress in this form). After a Speaker submits the "Speaker Information Form" you will receive an email and their submission will be logged below.

Speaker Information Form URL & Submissions

TO GENERATE YOUR FORM URL: Step #1: Make sure you have entered your Email Address on Page #1 of this Form (General Information). Step #2: Click the "Save Progress for Later" link below, to generate the link for your Speakers (they will all use the same URL) to submit their information through.

This field is hidden when viewing the form

Unique MA Token ID

Speaker Disclosure of Commercial Interests

It is best to request speakers to include a disclosure slide about 3 weeks from the meeting date when they are probably beginning to prepare their slides.

"For accreditation purposes, all speakers must disclose any possible conflict of interest regarding the topic that is being presented. A conflict of interest is defined as any financial interest of the speaker in a company’s products or services discussed in the presentation. This disclosure is not to censor or exclude speakers, but to inform the audience so that they may decide for themselves whether or not a presentation is biased. Please ensure that you include a disclosure slide at the beginning of your presentation."

Sample Disclosure Slide

Ethical Standards for Continuing Professional Education

Professional Development activities approved under Category 1 must meet the following guidelines. By clicking “I agree” in each case the Chair of the Committee assumes responsibility for ensuring the standards are met.

6. Enter a list of all commercial organizations that are funding this activity.(Required)

Evaluation Forms

Approved evaluation form

Professional Development Credits

Provide the ‘Personal Record of Attendance’ form to each delegate attending the conference. Fill in the list of presentations in advance along with the category and maximum number of credits for each session. Credits represent educational hours – eg. a 3-hour symposium with a half hour break has a maximum of 2.5 credits. The delegate will record the attendance codes as they appear in the session, for later submission of their credit claims.

Download "Personal Record of Attendance" Form

List of Sessions You Wish to be Included for CE Credits

Make a list of the sessions you wish to include for CE credit and the number of hours of instruction using the form Session List Form.

Download "Session List" Form

Session List(Required)

Drop files here or

Max. file size: 30 MB.

Attendance Codes

The organizer should contact the CSCC Office to receive the Attendance Codes for your sessions at least 3 weeks in advance of the meeting. The organizer then prepares a slide for each code/session which should be displayed at the conference at least once during each session. Each session will have a different code.

Participants then go to the CSCC website to enter their credits and receive a certificate of attendance.

Non-members can also use the codes to produce a certificate for their records. After entering the attendance codes, the non-member can print a Certificate of Attendance which they can use for their organization.

Accreditation Statement

Approved CPD events must have the following statement on the program materials:

“This event is an accredited group learning activity as defined by the CACB/CSCC Professional Development Program”

Application Form Submission

Before submission please ensure that you have uploaded all of the required supporting documents.

Applications received less than one month before the event start date are not guaranteed to be processed for credits.
Application Fee
$500 for the first day; $100 for each additional day. Payment is due upon approval of the accreditation.

Number of Days

Please enter a number greater than or equal to 1.

Application Fee

Price:

Additional Day(s) Fee

Price: $ 0.00 CAD

Subtotal

$ 0.00 CAD

GST

$ 0.00 CAD

(Alberta, British Columbia, Manitoba, Northwest Territories, Nunavut, Saskatchewan or Yukon)

HST

$ 0.00 CAD

(Ontario)

HST

$ 0.00 CAD

(New Brunswick, Newfoundland and Labrador, Nova Scotia or Prince Edward Island)

GST

$ 0.00 CAD

(Quebec)

PST

$ 0.00 CAD

(Quebec)

Tax

$ 0.00 CAD

(Non-resident)

Total

Meeting Accreditation Application Form

Meeting Accreditation Form

General Information

Person Requesting Approval

Committee Information

Needs Assessment

3. Needs Assessment

Learning Objectives

Speaker Information Form

Speaker Disclosure of Commercial Interests

It is best to request speakers to include a disclosure slide about 3 weeks from the meeting date when they are probably beginning to prepare their slides.

Alignment of Instructional Methods to Learning Objectives

Ethical Standards for Continuing Professional Education

Evaluation Forms

Professional Development Credits

List of Sessions You Wish to be Included for CE Credits

Attendance Codes

Accreditation Statement

Application Form Submission