Thank you for your interest in accredited continuing education (CE) for healthcare professionals! Please fill out this form to the best of your ability. If you are not sure how to respond, leave it blank or select the answer that best fits with your current plans. You will have the opportunity to make changes through out the planning process. A CE Specialist will contact you to discuss your activity.

Contact Information:
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Please list the UW School, Program or Department that is sponsoring the activity. If the sponsoring organization is a UW Health clinical department or unit, community-based organization, or if you are unsure, please enter "None."
Enter the name of the UW Health Clinical Department or Unit planning this series.
Enter the name of the non-UW company or organization that is sponsoring this activity.
Activity Details

NOTE: If you are planning a Regularly Scheduled Series (RSS) (e.g., grand rounds, case conference, journal club) as your activity type, please use the RSS Request Form instead.

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Enter the dates you plan to hold your course.
Enter the date that you would like your online enduring course to be available to learners.
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Planning Committee And Faculty
Everyone involved in planning, teaching, and/or reviewing content for an accredited continuing education activity must participate in the UW-Madison ICEP conflict of interest management process. This process requires that all planners, faculty, authors, and reviewers create an account in the UW-Madison ICEP Learning Portal. UW-Madison ICEP will contact these contributors to request a conflict of interest (COI) report.

List the names, credentials, and email addresses of people who are currently engaged in the planning process. This list may be updated throughout the planning process. 

 

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