Synergy Medical Education Alliance - Continuing Medical Education

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Continuing Medical Education
Information Form

If you would like to receive the monthly calendar issued by the Department of Continuing Medical Education at Synergy Medical, please complete the following form and email it to: Heather Turner, CME Coordinator.

The Department also tracks CME credits for physicians in Saginaw County. If you would like your credits tracked, please complete the form and check the box for credit tracking at the bottom. Please contact the Department of CME for fee schedules.

You may also print this blank form and mail it to Heather Turner at:

Synergy Medical
Department of CME
1000 Houghton Avenue
Saginaw, MI 48602

* - Required Fields

I am a(n) If Other: (please specify)

Specialty:

Subspecialty:

NAME

*First: *Last: MI:

PREFERRED MAILING ADDRESS

Organization:

*Address:

*City:
*State:	*Zip +4 Digit:

*County:
*Phone:
Fax:
Email:

Send me the CME monthly activities calendar.
Send me brochures for upcoming events.
Yes, I want the Synergy Medical Department of CME to track my CME credits.