CME Credit Application
Please complete this form to receive CME credit for attending "Biosimilars and Oncology: A Virtual Roundtable".


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Name *
Degree *
ie: MD, PhD, DO, etc.
Email *
Address *
ie 123 Main Street, Boston, MA 02178, USA
Specialty *
ie: oncology, hematology, dermatology, etc.
Number of patients seen per week *
Did this activity meet the stated objectives? *
This activity conveyed information that will assist me in improving the health of my patients. *
I agree that this program was fair, balanced, and free from commercial bias. *
The information presented enhanced my current knowledge base. *
The information presented provided new ideas or information that I expect to use. *
I intend to make changes to my practice based on the information gained in this program. *
What barriers do you anticipate, when incorporating best practices learned in this activity, into clinical activities or quality improvement initiatives at you institution?
How many CME credits are you requesting based on your participation in this activity? *
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