Acoem application for joint providership for continuing 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the 'Submitter’s Information' section. Enter your full name with credentials, email, and phone number. Specify the name of the component or section hosting the activity.
3. In the 'Activity Title' field, provide a clear title for your educational activity. Select the type of activity from the options provided: either in-person or live webinar.
4. Fill in the 'Activity Date' ensuring it is at least 60 days from submission. If applicable, include the location of the activity.
5. Indicate whether this activity is organized by an ACOEM section or component and specify if yes. Then, complete the 'Joint Providership Fees' section based on your entity type.
6. Provide a detailed description of your activity and identify any educational gaps that justify its necessity. List at least three learning objectives using active verbs.
7. Complete all required sections including faculty information, program planning committee members, and attach any necessary documents such as disclosure forms and Q&A sets.
8. Finally, sign and date the application before submitting it through our platform.

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