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Speaker Name Speaker Affiliation Presentation Title Speaker Name Speaker Affiliation

[FOR APHA USE ONLY] Attendance Code You will need this attendance code in order to access the evaluation and CPE form for this activity. Your CPE must be filed by December 2, 2016, at 1700 EST in order to receive credit.

CPE Information and Disclosures [INSERT FACULTY NAME(S)] [INSERT THE FOLLOWING TEXT IF NO CONFLICTS EXIST: “declare(s) no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.” OR LIST THE CONFLICTS] The American Pharmacist Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

CPE Information Target Audience: [FOR APHA USE ONLY] ACPE#: [FOR APHA USE ONLY] Activity Type: [FOR APHA USE ONLY]

Learning Objectives Objective 1 Objective 2 Objective 3

Self-Assessment Questions

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Speaker Name Speaker Affiliation Speaker Contact Closing Remarks Speaker Name Speaker Affiliation Speaker Contact

[FOR APHA USE ONLY] Attendance Code You will need this attendance code in order to access the evaluation and CPE credit for this activity. Your CPE must be filed by December 2, 2016, 1700 EST in order to receive credit.