CME Claim Form 2023 AHNS 11TH INTERNATIONAL CONFERENCE ON HEAD & NECK CANCER CME CLAIM The American Head and Neck Society (AHNS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide Continuing Medical Education for physicians.Your Name*As you wish it to appear on your certificate. Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Middle Last Suffix Email* Address* City State / Province / Region Are you a physician? (MD/DO)* Yes No Birth Month and Day* Example: 05/27Total Hours of Attendance Claimed:*Please enter a number from 0.25 to 32.25.The American Head and Neck Society (AHNS) designated this other [online live and online enduring] activity for a maximum of 32.25 AMA PRA 1 Credit(s)TM. Physicians should claim only the credit they commensurate with the extent of their participation in the activity.ABOHNS Part II Self-assessmentThese credits are only available for those who are Board certified in the United States. If you qualify please check the below checkbox. If not, you may submit to complete your claim. ABOHNS Part II Self-assessment I qualify to claim ABOHNS part II self-assessment credits ABO Number* Don’t know your number? Visit https://www.abohns.org/verify-certification/ HiddenDate* MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.