COE Program Accreditation Application
Page 1 - Sponsoring Organization
1. Name
*
2. Title
3. Company Name
*
4. Email Address
*
5. Phone Number
6. City, State
7. Message
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COE Program Accreditation Application
Page 2 - Program for which you are requesting COE credit
Program Title
Program Date
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Location
Learning Objectives
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COE Program Accreditation Application
Page 3 - Course Outline and Credits
Please attach a list of all courses including course times, presenters, and description of each course.
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Please check all that apply and enter the number of corresponding COE credits in each category in the question below
Category A: Ophthalmic specific management programs/courses, as well as technical and medical courses. Courses related to clinical patient care taught by industry device manufacturers or pharmaceutical companies are not eligible for COE credit. All Category A activities yield a 1:1 credit ratio of hours spent-to-hours earned.
Category B: General management/college courses. All Category B activities yield a 1:1 credit ratio of hours spent-to-hours earned.
Category C: Miscellaneous. Activities must be within the 6 COE content areas (general ophthalmic knowledge, financial management, operations, information technology management, human resources, risk management & regulatory compliance). Category C activities yield different credit ratios of hours spent-to-hours earned based upon the activity.
Number of credits:
Should be Empty: