Foundations to Environmental Medicine Faculty Form - American Academy of Environmental Medicine

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Name (Include medical credentials):*
Address
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*not to exceed 250 words. Include 2-3 references that provide the best evidence underlying your proposed talk.
Max. file size: 256 MB.

Please indicate which of the following conference objective(s) your presentation addresses:

Learning Objectives

Please identify three learning objectives that the participants will be able to improve upon or achieve after attending your session.

This is a change in:
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Teaching Methods

Please indicate which of the following teaching methods you will be using:
Please enter at least three questions for attendees to answer in relation to the content in your presentation. This will be utilized for CME Credit

ACCME and IOM Competencies

Please indicate which of the competencies below that you will be addressing in your presentation:

ACCME/ABMS Competencies
IOM Core Competencies

Biography


Disclosures

Have you (or your spouse/partner) had a personal financial relationship in the last 12 months with a commercial interest that produces health care goods or services consumed by, or used on patients that will be presented in this CME activity or in your presentation?
My presentation will include a discussion of “off-label” uses of a commercial product or an investigational use of a drug or device not yet approved. I will not use trade names of drugs.
Please explain below:

Important: Please check all your entries before clicking Submit

Please list at least 5 of the treatment strategies and/or Clinical Pearls that relate to your topic.

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