AAGL 52nd Global Congress

CME Evaluation & Credit Request form
Please complete this form to provide feedback and/or to request CME credits.

1. Enter your EMAIL ADDRESS. (Please use the same email address for all evaluations) *This question is required. This question requires a valid email address.

2. What is your FULL NAME with CREDENTIALS? (Please enter the name you want to appear on you CME Transcripts) *This question is required.

First Name
Last Name
Credentials (MD, DO, PhD, MPH)

Are you a physician? Physicians include MD's, DO's, or other country equivalent to an MD. PhD's are not considered to be physicians. *This question is required.

AAGL 52nd Global Congress - Nashville!