SAMPLE – NON-PHYSICIANS
CME CERTIFICATE
Certificate of Attendance
The University of California, San Diego School of Medicine Continuing Medical Education certifies that
__________________________________________________ has participated in the enduring material titled
[name of activity]
Venue: [type of format]
Start Date: [date]
End Date: [date]
This activity was designated for [# of credits] AMA PRA Category 1 Credits™.
CREDITS CLAIMED: ________
AAPA: Accepts AMA PRA Category 1 Credits™ from organizations accredited by the ACCME to grant Category 1 credit
BRN: For the purpose of recertification, the American Nurses Credentialing Center accepts AMA PRA Category 1 Credits™ issued by
organizations accredited by the ACCME. For the purpose of relicensure, the California Board of Registered Nursing accepts AMA
PRA Category 1 Credits™ (report up to XX hours of credit and list “CME Category 1” as the provider number).
Participants should claim only the credit commensurate with the extent of their participation in the activity.
________________________________
Terence M. Davidson, M.D.
Associate Dean, Continuing Medical Education
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Participant Signature
This certificate is for non-physicians.
If you have applied for a specialty accreditation, the correct specialty accreditation statement will be sent to
you on the approval letter once it has been approved.
List specialty credit (BRN, AAPA, MCEP, MFT, etc.) only if approval has been received by authorizing
agencies. All non-physician specialty credits must be listed on a separate certificate from AMA PRA
Category 1.
Please replace Dr. Davidson’s name and title with your UC San Diego Course Director/Course Chair.