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A Chapter of the Caribbean College of Family Physicians
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CCFP SECRETARIAT On-Demand On-Line CME…
CCFPAGPJ SECRETARIATOn-Demand On-Line CME Registration
Event Timing: Not applicable
Event Address: Online
Contact us at: 876-517-6636 or 876-386-1443 Email: ccfpsecretary@gmail.com
Please complete this form and submit for on demand, online CME
Name
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Name
First
First
Last
Last
Email
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Job or Specialty
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Telephone #
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Parish/Country
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Number of CMEs requesting
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Year requesting Online ondemand sessions?
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Date and Name of session you are requesting to watch On-Demand
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Do your Require:
Scientific Session
Mental Health & Wellness
Ethics
Other (please indicate)
Other (please indicate)
There are cost for CME certificates for sessions accessed on-demand, amounts will be billed after sessions have been watched and confirmation is received that the sessions have been watched and post test completed where applicable
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Noted
Please send a confirmation by email to us at ccfpsecretary@gmail.com or ccfpsecretariat@gmail.com after submission of this document
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Noted
Data Protection Notice: The CCFP Secretariat is committed to protecting your privacy and ensuring the security of your personal data. The information collected in this form will be used for the sole purpose of processing your request for the our ondemand-online sessions and/or invitation to CME event activities. Your data will be stored securely and will not be shared with third parties without your explicit consent. By completing this form, you acknowledge and consent to the processing of your personal data for the specified purpose. For more information, you may call us at 876-517-6636 or email us at agpjsecretary@gmail.com.
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Noted
A copy of your responses will be emailed to the address you provided.
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