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Attestation of MI AIM Activity for 2019 Maintenance of Certification Requirements
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AOA OCC PPA Description
First Name
*
Your answer
Last Name
*
Your answer
Email Address
*
Your answer
I have reviewed my email address above and it is correct.
*
YES
AOA ID (if known)
Your answer
Meaningful Participation Attestation
I attest that I met the meaningful participation requirements.
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Yes
Required
I participated in this QI effort MI AIM Collaborative as follows (check all that apply):
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Executive Committee
Data monitoring committee
Maternal mortality committee
Outreach/ Implementation committee
Implementation of the project’s interventions (the changes designed to improve care) at your site
Reviewed own site's data in keeping with the project’s measurement plan
Demonstrated active collaboration in the implementation of the activity at your site (e.g., team meetings, data analysis, implementation training, etc.)
Physician champion at site
Viewed or presented MI AIM coaching webinars (live or recorded - must attend 3 sessions if no other activities above)
Other:
Required
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