Application for endorsement of CME events

Providers who would like to have their CME events endorsed and promoted by RNZCUC should complete this form.

All applications must be received 4 weeks prior to your programme’s scheduled commencement date.

Application details
Provider name:*
Programme coordinator name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Programme details
Event title*
Type of CME/CPD (Online/Webinar, Quiz, Modules, Conference, Symposium) :*
Is the programme application for a single event or repeat event. If it is a repeated event, please elaborate on the frequency.
Number of educational hours involved in the event: (hours must not include lunch or tea breaks)
Proposed location (s):*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Proposed date (s):
MM slash DD slash YYYY
Brief description (please attach event programme) :
Event programme
Max. file size: 100 MB.
Relevance to Urgent Care
Please describe the relevance of this activity to Urgent Care. How will the programme improve the quality of clinical effectiveness in Urgent Care?
Please outline the expected learning outcomes of the programme.
Are there sections of the programme which may have more relevance to another vocational scope (such as General Practice, Internal Medicine, Emergency Medicine, Surgery)? If there is, please detail the proportion of the activity that may not be relevant to Urgent Care:
If participation in this programme is assessed, please describe how:
Who will present the programme? (Names of brief background information on presenters)
Are there any potential sources of bias, conflicts of interest or contentious issues that could affect the impartiality of the programme?
Have you previously received endorsement from the College for any other event?
- Yes
- No
If this is your first event, would you be able to provide a College representative with a Guest pass to attend the event to allow evaluation for RNZCUC endorsement of future events?
- Yes
- No
We require that doctors who wish to claim credits for CME activities maintain certificates of completion for all activities undertaken. Do you have the capacity to maintain records of participation, and to issue certificates?
- Yes
- No
Comments
This field is for validation purposes and should be left unchanged.

Application for endorsement of CME events

Application details

Programme details

Relevance to Urgent Care