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34th Annual Winter Conference CME Form
Hours will be reported to the AOA and CE Broker.
All forms must be submitted within 2 weeks of event.
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First Name
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Last Name
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Email
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Date
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YYYY
AOA #
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License #
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CME Hours
Total Hours Offered = 27 Category 1A CME available
Total Hours Attended
(You will receive the number of hours indicated below)
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If not claiming the full 27 hours, please verify your hours below:
Number of General Hours
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Number of Mandated Hours
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