Kirksville College of Osteopathic Medicine Request for Preceptor CME Credit

***๐“๐ก๐ข๐ฌ ๐Ÿ๐จ๐ซ๐ฆ ๐ข๐ฌ ๐ฌ๐ฉ๐ž๐œ๐ข๐Ÿ๐ข๐œ๐š๐ฅ๐ฅ๐ฒ ๐Ÿ๐จ๐ซ ๐Š๐‚๐Ž๐Œ ๐ญ๐ก๐ข๐ซ๐ ๐š๐ง๐ ๐Ÿ๐จ๐ฎ๐ซ๐ญ๐ก ๐ฒ๐ž๐š๐ซ ๐œ๐ฅ๐ข๐ง๐ข๐œ๐š๐ฅ ๐ซ๐จ๐ญ๐š๐ญ๐ข๐จ๐ง๐ฌ.***

Thank you for serving as a clinical preceptor for third and/or fourth year KCOM medical students. ย Please complete the form below to request your CME credit.

The Clinical Performance Evaluation for the rotation must be submitted by the preceptor before CME credit will be issued.

Credit requests must be submitted within one year following the completion of the rotation in order to be processed.ย 

๐ƒ๐Ž ๐๐ก๐ฒ๐ฌ๐ข๐œ๐ข๐š๐ง๐ฌ:
Credit for osteopathic physicians is submitted to the AOA on a quarterly basis (April, July, October, January).
Credit requests must be submitted within one year following the completion of the rotation in order to be processed by the AOA.

๐Œ๐ƒ ๐๐ก๐ฒ๐ฌ๐ข๐œ๐ข๐š๐ง๐ฌ:
Credit is processed on a quarterly basis (April, July, October, January).
CME certificates will be emailed directly to the email address provided within this form.

Questions: Clinical Affairs 660.626.2513

To request credit for:
๐’๐Ž๐Œ๐€ (AZ) ๐ฌ๐ญ๐ฎ๐๐ž๐ง๐ญ๐ฌ: www.atsu.edu/continuing-education/preceptorsย and click on SOMA medical students
๐„๐š๐ซ๐ฅ๐ฒ ๐‚๐ฅ๐ข๐ง๐ข๐œ๐š๐ฅ ๐„๐ฑ๐ฉ๐ž๐ซ๐ข๐ž๐ง๐œ๐ž๐ฌ (second year students): Call the Missouri AHEC Program 660.626.2887

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