Attachments

Attachment 1 - PNUM_Activity Topic/Content:

N/A

The activity topic/content, e.g., agenda, brochure, program book, announement, or instructional materials. If this activity is an enduring material, journal-based CE, or Internet CE, please included the actual CE product (or a URL and access code – if applicable) with your performance–in-practice.

Attachment 2A- PNUM_Tool to Identify Relevant Financial Relationships:

N/A

The form, tool, or mechanism used to identify relevant financial relationships of all individuals in control of content. [JAC 12, SCS 2.1] (NOTE: include completed disclosure document of an individual in control of content for this activity.)

Attachment 2B - PNUM_Tool to Identify Relevant Financial Relationships:

N/A

The form, tool, or mechanism used to identify and mitigate relevant financial relationships of all individuals in control of content. [JAC 12, SCS 2.1] (NOTE: See instructions on page 1 - include table or attachment (completed DDF) with relevant financial relationships of all individuals in control of content for this activity.)

Attachment 3 - PNUM_Relevance/Absence of Financial Relationships Disclosure Information to Learners:

N/A

The disclosure information as provided to learners about the relevant financial relationships (or absence of relevant financial relationships) that each individual in a position to control the content of CE disclosure to the provider [JAC 9, SCS 6.1-6.2,6.5]

Attachment 4 – PNUM_Changes in Healthcare Team Skills/Strategies or Performance or Patient Outcome:

N/A

The data or information generated from this activity about changes in the healthcare teams’ skills/strategy or performance and/or patient outcomes

Attachment 5 – PNUM_Joint Accreditation Statements to Learners:

N/A

The Joint Accreditation statement for this activity, as provided to learners. [Appropriate Joint Accreditation Statement]

If the activity was COMMERCIALLY SUPPORTED...

Attachment 6 – PNUM_Income and Expense:

N/A

The income and expense statement for this activity that details the receipt and expenditure of all of the commercial support.

Attachment 7 – PNUM_Fully Executed LOA:

N/A

Each executed commercial support agreement for the activity [JAC 9, SCS 3.4-3.6]

Attachment 8 – PNUM_Commercial Support Disclosure Provided to Learners:

N/A

The commercial support disclosure information as provided to learners [JAC 9, SCS 6.3-6.5]