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Presentation Title. Speaker Name Speaker Affiliation. Attendance Code. [FOR APHA USE ONLY]. You will need this attendance code in order to access the evaluation and CPE form for this activity. Your CPE must be filed by November 19, 2014, at 1700 EST in order to receive credit.

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  1. Presentation Title Speaker Name Speaker Affiliation

  2. Attendance Code [FOR APHA USE ONLY] You will need this attendance code in order to access the evaluation and CPE form for this activity. Your CPE must be filed by November 19, 2014, at 1700 EST in order to receive credit.

  3. CPE Information and Disclosures [INSERT FACULTY NAME(S)] [INSERT THE FOLLOWING TEXT IF NO CONFLICTS EXIST: “declare(s) no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.” OR LIST THE CONFLICTS] The American Pharmacist Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

  4. CPE Information • Target Audience: [FOR APHA USE ONLY] • ACPE#: [FOR APHA USE ONLY] • Activity Type: [FOR APHA USE ONLY]

  5. Learning Objectives • Objective 1 • Objective 2 • Objective 3

  6. Self-Assessment Questions • Question 1 • Question 2 • Question 3

  7. Slide Content • Slide content starts here (add slides as needed)

  8. Key Points • [INSERT KEY POINTS OF PRESENTATION AS REVIEW FOR AUDIENCE]

  9. Answers To Self-Assessment Questions • Question 1 and answer • Question 2 and answer • Question 3 and answer

  10. Closing Remarks Speaker Name Speaker Affiliation Speaker Contact

  11. Attendance Code [FOR APHA USE ONLY] You will need this attendance code in order to access the evaluation and CPE credit for this activity. Your CPE must be filed by November 19, 2014, 1700 EST in order to receive credit.

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