2023 Summer Speaker Proposal
Please read the summary section and instructions thoroughly before completing the form.  The deadline to submit is March 15, 2023.

SUMMARY: NCAPA conferences focus on Category 1 CME for Physician Assistants.  Presentations must be free of commercial influence and meet the criteria for AAPA Category 1 CME credit.  This includes:
  • Be balanced and have relevance to PA practice either through their ability to improve patient care or to provide better systems of health care.
  • Be based on topics derived from an assessment of the needs of PAs.
  • Be formally planned and designed as part of an ongoing CME activity.
  • Demonstrate high educational, ethical, and medical standards.
  • Include explicit learning objectives.
  • Include a participant evaluation method assessing the quality of the program as well as the extent to which it met the stated learning objectives.
  • Be free of product-specific advertising, promotional logos, or slogans.
  • Meet AAPA’s Standards for Commercial Support of CME programs - https://www.accme.org/accreditation-rules/standards-for-integrity-independence-accredited-ce
INSTRUCTIONS: One form should be submitted for each individual topic/proposed session. For multiple topics/sessions to be considered, you must utilize a separate form for each.  

The deadline to submit is March 15, 2023.  All proposals are reviewed by the NCAPA Professional Development Review Panel.  Selected presenters will be notified no later than mid April 2023.  Only selected presenters are notified.  
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First Name *
Last Name *
Employer  *
Designation/Credentials *
Work Title (if different than designation)
Specialty (if none, type none) *
Email Address *
Cell Phone/Main Number *
City of Residence *
State of Residence *
In the past 3 years, I have spent approximately this percentage of my time in direct clinic/patient care.  *
In the past 3 years, I have spent  approximately this percentage of my time in academia/administration. *
Provide the following:  1) a detailed description of your experience as a speaker, educator, clinician and 2) include examples of conferences, events, or classes where you have lectured. *
LECTURE Title *
LECTURE Description *
List 3-5 Learning Objectives (must list at least 3 distinct objectives). *
What percentage of this 1-hour lecture qualifies for Controlled Substances? Additional information here. *
What percentage of this 1-hour lecture qualifies for Pharmacology?  Additional information here.  *
I am available to conduct my presentation: *
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