The Office of Continuing Medical Education is currently seeking information to assist with the planning of future CME programs. In order to fit the specific needs of physicians, we are asking you to identify areas where you perceive education programs would be desirable. Thank you for your time and for helping us to improve our Continuing Medical Education Program.

You may submit the form in one of three ways:

1. Fill out the form online by typing the information in the fields / checking the appropriate boxes, then print it out using your browser's print function and mail it to:

   Michigan State University
   Kalamazoo Center for Medical Studies
   Continuing Medical Education Department
   1000 Oakland Drive
   Kalamazoo, MI 49008

2. Do the same as above but FAX the printout to 269-337-4234.
3. Do the same as above, but choose the "Submit" button below, instead of printing, to e-mail the completed form to us.