RSS Forms and Procedures

RSS process and credit application forms

• Accreditation Portal: This is an electronic form. If this is your first time applying for CME credit for a Regularly Scheduled Series, please email Wendy Murphy at wendy.m.murphy@hitchcock.org prior to starting the application.
• Responsibilities of Individuals Involved (DOCX)
• How to Write a Learning Outcome Statement (DOCX)
• Eligibility of a Course Director (DOC)

ACCME references

• ACCME Standards for Commercial Support

RSS sample forms

For all RSS programs

• Accreditation and Credit Designation Statement (DOCX)
• Financial Disclosure and Agreement Form (DOCX)
• Financial Disclosure and Agreement Form (PDF)
• Financial Disclosure Mitigation Form (DOCX)
• Financial Disclosure Mitigation Form (PDF)
• Sample RSS flyer, email, or announcement (DOCX)
• RSS Cover Sheet (without conflict of interest) (DOCX)
• RSS Cover Sheet (with conflict of interest) (DOCX)
• Attendance Attestation Form
• Webcast Release Form (PDF)

For traditional RSS programs

Traditional programs are those that have a different speaker each week.

• Attestation Form for Traditional RSS to document disclosure (PDF)