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Month Day, Year Hospital Name City, State Speaker’s Name

Sentara Healthcare CME Program “ Title of Presentation ” Target Audience: SELECT : Primary Care Physicians and Providers, Oncologists, Radiologists, Surgeons, Internal Medicine, Specialty Physicians & Other Healthcare Providers. Month Day, Year Hospital Name City, State Speaker’s Name.

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Month Day, Year Hospital Name City, State Speaker’s Name

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  1. Sentara Healthcare CME Program“Title of Presentation”Target Audience: SELECT: Primary Care Physicians and Providers, Oncologists, Radiologists, Surgeons, Internal Medicine, Specialty Physicians & Other Healthcare Providers Month Day, Year Hospital Name City, State Speaker’s Name

  2. Objectives: 1. Objective 1 2. Objective 2 3. Objective 3

  3. Acknowledgement of Educational Grant: • This program was made possible, in part, by an unrestricted educational grant from Pharmaceutical Company Name. We would like to thank Pharmaceutical Company Name for their support of this activity.

  4. HIPAA As an attendee for this program, please comply with the requirements to protect health information under the Health Insurance Portability & Accountability Act of 1996 (HIPAA).

  5. Sentara Healthcare CME Program Accreditation Sentara Healthcare is accredited by the Medical Society of Virginia (MSV) to provide continuing medical education for the physicians.

  6. Credit Designation Sentara Healthcare designates this educational activity for a maximum of (1 hour) AMA PRA Category 1 Credit TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Virginia Board of Medicine Physicians may claim up to (1 hour) in Type 1 or Type 2 CME on the Virginia Board of Medicine Continued Competency and Assessment Form required for renewal of active medical license.

  7. Bio Sketch • Speaker’s Namereceived his M.D. from the University of Missouri Medical School in Columbia, MO. He then went on to complete his residency at the Medical College of Virginia. He is currently the Medical Director for the Pulmonary Hypertension Service and the Lung Transplant Service at the Medical College of Virginia in Richmond.

  8. Disclosure of Relevant Financial Relationship with Commercial Companies/Organizations • Speaker’s Name has disclosed a financial relationship with the following manufacturers of commercial products, which may be a direct interest in his presentation. He is on the Speaker’s Bureau for Actelion, and has received a grant for research for Myogen. • Speaker’s Namehas resolved any conflict of interest that may be perceived from this relationship. • The CME Committee and CME Coordinators for this event have disclosed NO relevant financial relationship for this presentation.

  9. Announcements Cell Phones and Pagers While attending this program, please put your cell phones and pagers on a no sound, vibration mode or turn them off. Telephone is available outside of the conference room.

  10. Evaluation Forms Take a moment to complete the evaluation form on your table. Evaluations are important assessment tool that will help us in planning future programs. Please submit them to the CME coordinator.

  11. Sentara Healthcare CME Program TOPIC for next Thursday: “Advance in Imaging” October 13, 2005 Speaker: Theodore Dorsay, MD Radiologist Advanced Imaging Center Sentara Leigh Hospital

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