Continuing podiatric medical education answer form

CONTINUING PODIATRIC MEDICAL EDUCATION ANSWER FORM ISSUE

Month Volume

y ea r

I

-l-

_

Number

Assigned CPME I.D. Num ber*

_ _ _

Cur re nt ACFAS Memb er 0 YES 0 NO NAME

_

ADDRESS

_

PHONE,

FAX

SS#

_

1. D D D D D

A B C D E

2. 0 A D B DC D D D E

3. 0 A DB D C D O D E

4. 0 D D D D

A B C D E

5. 0 A D B DC DD D E

6. 0 D D D D

A B C D E

7. 0 A D B DC D D D E

8.0 D D D D

9. 0 D D D D

A B C D E

10. 0 A D B DC D D D E

A B C D E

_ State

IN STR UCTIONS: Please return the answer form to Data Trace Publishing Compa ny for gradi ng . There is a f ee of $15.00 per issue ($12.00 fo r ACFAS m emb ers ) f or scoring and proce ssing, payable in advance. Please make checks payab le to Data Trace Publishing Compa ny. All test results are confidentia l. You will be notified of the results within 30 days by return mail. You will be respon sible for notifyin g your state of the number of credits you have received. The fee for a retak e exam is $5.00, payab le in advance. Any question s or inquiries regarding the The Journal of Foot & Ankle Surgery Cont inuing Education Program sho uld be directed to: Contin uing Education Director Data Trace Publishing Company P.O. Box 1239 Brooklandville , MD 2102 2-9978 Or call (410) 494-4994

NOTE: All applican ts 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 Publishin g Compan y. First-tim e CPME participants will not have an assigned CPME J. D. numb er; please leave blank.

THE JOURNAL OF FOOT & ANKLE SURGERY Co pyright") 1999 by the Ame rica n College of Foot and Ankle Surgeo ns

Lice nse Number

State License

k1ISSION STATEk1ENT Data Trace Publishing Company, a CPMEapp roved spo nsor ofcontinuing education in podiatric medicine with authorization to sponsor instru ctional media, prov ides highquality continuing education programs through appropriate and effec tive media in order to meet the educational needs of the podia tric medical profession and thereby enhance the quality of patient care. Th e objectives of The Journal of Foot & Ankl e Surgery CPME instructional med ia progra m are to increase the leve l of know ledge and skills, increase the ge nera l level of com petency , and enhance the quali ty of patient care by providing a broad overview of curren t, origi nal, medical and surgical literature of high interest to the podia tric medical profe ssion in a reinfo rced learning environment.

Volum e 38. Number 5. September/Oct ober 1999

VOLUME 38, NUMBER 5, SEPTEMBER/OCTOBER 1999

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