Request form accreditation

REQUEST FOR ACCREDITATION:

CME-credits are only awarded when:

1. the subject refers to radiology
2. there is an abstract book available
3. there is a list of participators available
4. participators receive a personal certificate
5. a request for accreditation is presented to the president of the Accreditation Committee of the Radiological Society of the Netherlands
6. an official programme is sent to the Accreditation Committee preferably by e-mail

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:

Evaluation:

Abstract book available:

Attendance list will be kept:

Participators receive a personal certificate:

Single time / repeated activity:

Name, email + signature organisation:

 

Please send or mail this form AND PROGRAMME to:
email to: nvvr@radiologen.nl
fax to:+31-73-6142045
Send to: PO Box 1988, 5200 BZ ‘s-Hertogenbosch the Netherlands