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 SPECIFIED AND DEFINITIVE PROGRAMME to:
email to: nvvr@radiologen.nl
fax to:+31-73-6587092
Send to: PO Box 2082, 5260 CB Vught the Netherlands