To ensure compliance with AGD PACE requirements and uphold the integrity of the continuing education program, all joint program provider activities must be supported by appropriate documentation.
Forms and Agreements
Below is a complete list of the required forms and agreements necessary for all AGD-PACE joint Program provider CE Activities..
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Joint Program Provider Agreement – Defines the collaborative relationship and content responsibilities of the Joint Program Provider and CE Zoom .
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Disclosure of Financial Relationships – The disclosure of relevant financial relationships between of those involved in the planning, administering or delivering of the CE Activity to the content being discussed in the CE Activity.
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Affidavit of Image Authenticity & HIPAA Compliance – This affidavit confirms that all images used in course materials are authentic, unaltered, and used with proper consent, and if patient photos and clinical outcomes are involved that they are used in compliance with HIPAA privacy regulations.
All forms must be completed, signed, and submitted prior to the course to maintain AGD-PACE standards and provide a seamless, compliant CE experience for participants.
Role-Based Required Forms
Click the links below to jump to the required forms for each role involved in the joint program provider program
Joint Program Provider (CE Activity Offering Company) Specific Forms
Instructor Forms & Agreements
1. CE Zoom's & AGD-PACE Joint Progam Provider Policies & Procedures (Read)
- All organizations working with CE Zoom Partners, LLC must understand and follow AGD-PACE Standards when delivering a CE Activity. This document outlines those standards along with CE Zoom’s policies—please read and reference it when submitting course materials.
2. AGD-PACE Program Guidelines (Read)
- All organizations partnering with CE Zoom must understand and follow the 13 AGD-PACE Program Standards. CE Zoom requires full compliance with these guidelines for all CE Activities.
3. Affidavit of Image Authenticity & HIPAA Compliance (Sign 1 per course)
- A signed form must be obtained from all course instructors for each CE Activity. Instructors are to attest to taking the necessary steps to ensure that images and discussion of patients in the CE Activity is done so without falsification or misrepresentation of patient outcomes and the proper patient consent has been obtained. (CERP, VII-C-(8)) (PACE, VIII-C-(E))
Offering Company Forms & Agreements
1. CE Zoom's & AGD-PACE Joint Progam Provider Policies & Procedures (Read)
- All organizations working with CE Zoom Partners, LLC must understand and follow AGD-PACE Standards when delivering a CE Activity. This document outlines those standards along with CE Zoom’s policies—please read and reference it when submitting course materials.
2. AGD-PACE Program Guidelines (Read)
- All organizations partnering with CE Zoom must understand and follow the 13 AGD-PACE Program Standards. CE Zoom requires full compliance with these guidelines for all CE Activities.
3. Joint Program CE Provider Agreement (Sign Yearly)
- When two or more organizations work together to offer educational activities, the AGD Council recommends that a written plan or agreement is developed before committing to the CE activity to ensure that all parties involved are clearly aware of each other’s responsibilities to ensure a successful program. All organizations are required to sign this form prior to the delivery of the CE Activities with CE Zoom. This will serve as documentation of the organization's responsibility to adhere to and work in accord with the “Joint Program Provider Policy and Procedures” when entering into a contracting arrangement with CE Zoom. The Joint Program Provider agreement is valid for 365 days, upon signature.
4. Disclosure of Financial Relationships (Sign 1 per course)
- This form must be completed prior to delivery of the CE Activity. In order for the CE Zoom planners to identify, prevent and mitigate conflicts of interest in the creation and delivery of the educational content, disclosure of financial relationships between the Instructors and commercial entities must be made known to CE Zoom. (CERP, (V.12)) (PACE, (XII-C-(G))