goto Indian Health Service home page  Indian Health Service:  The Federal Health Program for American Indians and Alaska Natives

 
     HOME      ABOUT  I H S   SITE MAP     HELP
goto Health and Human Services home page goto Health and Human Services home page
Clinical Support Center (CSC) logo
 
Sponsorship Checklist For Submitting Activity Proposals
All Continuing Education (CE) activity proposals must be submitted to the IHS Clinical Support Center, Office of Continuing Education, at least 30 calendar days before the activity, if at all possible.

The minute you think of a CE activity, give us a call or send an email notice. We will guide you through the sponsorship process and your notification will alert us of your upcoming event. Please remember that we cannot award CE hours after the fact.

  • Notify CSC regarding a new activity
  • Form a planning committee representative of the target disciplines

 

For new activities, the following items must be completed and submitted prior to the start of the activity [printable checklist-PDF icon-49KB]:
____ 1. Submit Proposal
  1. One Hour Activity – for a one-time, one hour activity. [fillable form PDF icon-293KB]
  2. Hourly Series – for one to two hour long activities held on a weekly or monthly basis. [fillable form PDF icon-234KB]
  3. Regular – for activities that are from three hours in length to several days, e.g., a three day conference, seminar, or workshop. [fillable form PDF icon-249KB]
____ 2. Identify need for training; explain briefly the methodology used for needs assessment.
  1. Needs Assessment Fillable Form [PDF icon-239KB]
____ 3. Draft Agenda, showing start and end times, breaks, lunch, etc. The agenda is used to calculate the number of credit hours.
____ 4. Draft Content Outline and Learning Objectives
  1. Content Outline Fillable Form [PDF icon-214KB]
  2. How to Write Objectives [PDF icon-18KB]
____ 5. Identify the speaker(s) and provide background information to show expertise in subject
  1. Speaker Information Sheet Fillable Form [PDF icon-210KB]
  2. Faculty List, PDF icon-18KB] if many speakers involved. For single speakers, you may include this information on the course materials.
  3. Copy of Speaker Letter
  4. [PDF icon-21KB]
____ 6. Every member of the planning committee and each presenter must submit a Disclosure Form as it relates to the educational activity.
  1. fillable form [PDF icon-378KB]
____ 7. Evaluation plan to measure overall effectiveness of speaker/objectives/learning environment, etc.
  1. Evaluation Tool Sample
  2. [PDF icon-12KB]
____ 8. Draft Publicity/Marketing materials with correct sponsorship and credit statements. A final copy must be submitted for review and comment before it is distributed.
  1. Sample Brochure
  2. [PDF icon-35KB]
  3. Sample Flyer
  4. [PDF icon-11KB]
____ 9. Attendance Data to be submitted post meeting.
  1. Sample Sign-In Sheet
  2. [PDF icon-13KB]
  3. Summary Attendance FormPDF icon-18KB]

Clinical Support Center
40 North Central Avenue, Suite 780 • Phoenix, AZ 85004 • 602.364.7777 • 602.364.7788-fax
Accessibility  --  Disclaimer  --  Website Privacy Policy  --  Freedom of Information Act
Kids Page  --  Frequently Asked Questions  --  USA.gov  --  HHS

This file last modified: Wednesday January 10, 2007  12:16 PM