Continuing Education Disclosure Form to Download

Disclosure Form

MD's & PhD's

Due One Month Before Meeting

Click on the PDF icon to download the CAPS Disclosure Form.

Checklist for Completing Disclosure Forms

  1. Clearly write your name where indicated

  2. Include your group number on the form

  3. You must sign this form by hand. Electronic signatures are not acceptable.

  4. Submit your disclosure form to our Administrator:

 

Please note that any Disclosure Form returned without a legibly written name will be DISCARDED.

This form is due 1 month prior to each and every meeting weekend. No late disclosures can be accepted. Without this form we are unable to award CE credits. This is not a CAPS rule but a requirement of our sponsor. Please contact Michelle Ladew with any questions: caps_michelle@yahoo.com

CAPS Privacy Policy:

CAPS does not share any member information with third parties.

Michelle Ladew
Administrative Director

 

P.O. Box 3862
Nashua, NH 03061

 

caps_michelle@yahoo.com
1-800-757-5359

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