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Continuing medical education answer form
CONTINUING MEDICAL EDUCATION ANSWER FORM ISSUE
Month Volume
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year Number
Assigned I.D. Number"
_ _ _
Current ACFAS Member 0 YES 0 NO NAME
_
ADDRESS
PHONE SS#
_
FAX
2.0 A DB DC DD DE
3.0 A DB DC DD DE
4.0 A DB DC DD DE
5.0 A DB DC DD DE
6.0 A DB DC DD DE
7.0 A DB DC DD DE
8.0 A DB DC DD DE
9.0 A DB DC DD DE
10.0 A DB DC DD DE
_
_
State
INSTRUCTIONS: Please return the answer form to Data Trace Publishing Company for grading. There is a fee of $15.00 per issue ($12.00 for ACFAS members) for scoring and processing, payable in advance. Please make checks payable to Data Trace Publishing Company. All test results are confidential. You will be notified of the results within 30 days by return mail. You will be responsible for notifying your state of the number of credits you have received. The fee for a retake exam is $5.00, payable in advance. Any questions or inquiries regarding the The Journal of Foot & Ankle Surgery Continuing Education Program should be directed to: Continuing Education Director Data Trace Publishing Company P.O. Box 1239 Brooklandville, MD 21022-9978
License Number
State License
MISSION STATEMENT Or call (410) 494-4994
NOTE: All applicants for credit must be current subscribers to The Journal of Foot & Ankle Surgery or current members of ACFAS in good standing.
*Assigned by Data Trace Publishing Company. First-time CME participants will not have an assigned I.D. number; please leave blank.
THE JOURNAL OF FOOT & ANKLE SURGERY Copyright'" 2001 by the American College of Foot and Ankle Surgeons Volume 40, Number 5, September/October 2001
348
l.DA DB DC DD DE
THE JOURNAL OF FOOT & ANKLE SURGERY
Data Trace Publishing Company, a CPMEapproved sponsor ofcontinuing education in podiatric medicine with authorization to sponsor instructional media, provides highquality continuing education programs through appropriate and effective media in order to meet the educational needs of the podiatric medical profession and thereby enhance the quality of patient care. The objectives of The Journal ofFoot & Ankle Surgery CME instructional media program are to increase the level of knowledge and skills, increase the general level of competency, and enhance the quality of patient care by providing a broad overview of current, original, medical and surgical literature of high interest to the podiatric medical profession in a reinforced learning environment.
Month Volume
---"--I _
year Number
Assigned I.D. Number"
_ _ _
Current ACFAS Member 0 YES 0 NO NAME
_
ADDRESS
PHONE SS#
_
FAX
2.0 A DB DC DD DE
3.0 A DB DC DD DE
4.0 A DB DC DD DE
5.0 A DB DC DD DE
6.0 A DB DC DD DE
7.0 A DB DC DD DE
8.0 A DB DC DD DE
9.0 A DB DC DD DE
10.0 A DB DC DD DE
_
_
State
INSTRUCTIONS: Please return the answer form to Data Trace Publishing Company for grading. There is a fee of $15.00 per issue ($12.00 for ACFAS members) for scoring and processing, payable in advance. Please make checks payable to Data Trace Publishing Company. All test results are confidential. You will be notified of the results within 30 days by return mail. You will be responsible for notifying your state of the number of credits you have received. The fee for a retake exam is $5.00, payable in advance. Any questions or inquiries regarding the The Journal of Foot & Ankle Surgery Continuing Education Program should be directed to: Continuing Education Director Data Trace Publishing Company P.O. Box 1239 Brooklandville, MD 21022-9978
License Number
State License
MISSION STATEMENT Or call (410) 494-4994
NOTE: All applicants for credit must be current subscribers to The Journal of Foot & Ankle Surgery or current members of ACFAS in good standing.
*Assigned by Data Trace Publishing Company. First-time CME participants will not have an assigned I.D. number; please leave blank.
THE JOURNAL OF FOOT & ANKLE SURGERY Copyright'" 2001 by the American College of Foot and Ankle Surgeons Volume 40, Number 5, September/October 2001
348
l.DA DB DC DD DE
THE JOURNAL OF FOOT & ANKLE SURGERY
Data Trace Publishing Company, a CPMEapproved sponsor ofcontinuing education in podiatric medicine with authorization to sponsor instructional media, provides highquality continuing education programs through appropriate and effective media in order to meet the educational needs of the podiatric medical profession and thereby enhance the quality of patient care. The objectives of The Journal ofFoot & Ankle Surgery CME instructional media program are to increase the level of knowledge and skills, increase the general level of competency, and enhance the quality of patient care by providing a broad overview of current, original, medical and surgical literature of high interest to the podiatric medical profession in a reinforced learning environment.