Request form for CME accreditation of an activity outside of the Netherlands

CME-credits are only awarded when:

* the subject refers to radiology

* there is a list of participators available

* participators receive a personal certificate

* a request for accreditation is presented to the Accreditation Committee of NVvR

* an official programme is sent to the Accreditation Committee 

Please fill in:

CME/CDP activity: .......................................

Amount of hours (excluding coffee break): .....................................

Title: ............................................

Organisation/establishment: .............................................

Date: ..............................................

Place: ............................................

Targetgroup: .........................................

Area of learning: ........................................

Context (presentations, workshop etc): .........................................

Examination: yes/no

Evaluation: yes/no

Abstract book available: yes/no

Attendance list will be kept: yes/no

Participators receive a personal certificate: yes/no

Single time / repeated activity: ........................

Name, email + signature organisation (for questions about CME request): ......................................

 

Please send or email this form AND SPECIFIED AND DEFINITIVE PROGRAMME to the office of NVVR:
email nvvr@radiologen.nl