1. Please list your contact information, government Point of Contact (as applicable), Defense Health Network, Military Treatment Facility (MTF), and/or Organization. *

2. How many Continuing Education/Continuing Medical Education (CE/CME) events do you have planned for Calendar Year 2024 (CY24)? *

3. Please list the name and planned dates/date ranges for your CE/CME activities in CY24. Please indicate for each activity, the estimated number of CE/CME hours, and if your activity format is live or enduring. If you do have enduring activities, please note where the enduring content/video will be housed? *

4. How many of your activities will use the same content and be offered more than once? *

5. Have you consulted with the respective center of excellence (i.e., Hearing Center of Excellence, Vision Center of Excellence, etc.) regarding the topics/themes of your course(s) for consistency and collaborative purposes? *

6. Do you have any recommendations for topics/speakers/moderator for the CY24 Clinical Communities Speaker Series (CCSS)? If so, please list the topics and/or name of the speaker(s) POC and contact information below. *

7. Are there any new/emerging medical topics you would like to learn more about? If so, please list them below. *

8. CEPO is requesting new volunteer Content Reviewers for the 2024. If you are available, please enter your profession and email. *

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