Forms Report


IDForm TitleDate Created2024 Entries2025 Entries2026 EntriesAll Entries
8Medical Student and Resident Physician Join10-14-2014000145
203 Rs of Prescribing Controlled Substances Faculty Documentation04-29-20150006
42Content Development - CME Accredited Activity(2)03-10-20160000
50EXHIBIT ENTRY FORM05-03-201600011
622018 Annual Scientific Assembly Abstract Presentation Confirmation07-19-201600043
84Exhibitor Information03-24-201700064
87Southern Region Burn Conference - Online Exhibit/Sponsorship Application04-07-201700021
90Medical Student Join05-26-20170001
99Meeting Evaluation and Attendance Template08-22-201700018
1072018 SMA Women's Health CME Conference - Online Exhibit/Sponsorship Application11-13-20170007
1112018 Emerging Issues in U.S. Healthcare Policy Faculty Form01-18-201800016
1142018 Burn Conference Call for Abstracts02-06-201800091
1192018 Medical Summit Call for Abstracts02-08-20180000
1202018 SMA Assembly - Call for Abstracts02-08-201800049
1222018 SMA Medical Dilemmas - Online Exhibit/Sponsorship Application03-14-20180000
1252018 SMA's Annual Scientific Assembly - Online Exhibit/Sponsorship Application03-21-20180000
129Southern Region Burn Advertising04-19-20180002
136President Elect-Designate06-07-20180002
137Disclosure Information - 2018 SGS Annual Course in Advanced Gynecologic Surgery06-15-201800018
141Clinical Care Options, LLC08-07-20180005
1512019 Leadership Acceptance Agreement12-12-20180004
1542018 Burn Conference Call for Abstracts (1)01-04-20190000
1552019 Burn Conference Call for Abstracts01-04-2019000142
1562019 Southern Regional Assembly - Call for Abstracts01-14-201900060
1572019 Southern Regional Assembly Abstract Presentation Confirmation01-17-201900054
1602019 Emerging Issues - Evaluation and Attendance02-18-201900020
1642019 Southern Regional Assembly - Abstract Acknowledgment05-13-201900010
1682019 Comparative Healthcare Systems05-28-201900014
172The Tongue: A Mighty Muscle - Meeting Evaluation and Attendance06-25-20190000
173Disclosure Information - 2019 SGS Annual Postgraduate Course in Advanced Gynecologic Surgery07-10-201900018
1742019 Alabama Healthcare Fraud Summit07-30-20190000
1762019 Member Satisfaction Interview07-30-20190004
178Renewals08-13-2019215254731434
1832019 Southern Region Burn Conference - Abstract Presentation Confirmation08-20-2019000120
186Southern Region Burn Conference 2019 - Meeting Evaluation and Attendance10-08-2019000300
188Disclosure Information - 2020 - Workshop on the Difficult Airway11-05-20190007
192Workshop on the Difficult Airway - 02/08/202001-15-202000038
1932020 Burn Conference Call for Abstracts 01-21-202000067
194Disclosure Information - 2020 - Managing Health Care Policy02-10-202000013
1952019 Emerging Issues - Attendance Attestation02-13-20200001
1962019 Comparative Healthcare Systems - Attendance Attestation02-14-20200001
1972019 Functional Frenectomies Across a Lifespan - Attendance Attestation02-14-20200000
1982019 Focus on Women's Health CME Conference - Attendance Attestation02-14-20200001
2012020 Southern Regional Assembly - Call for Abstracts03-06-2020000130
203Strategically Managing Health Care Policy - Meeting Evaluation and Attendance - 6.13.202103-18-202000016
240SMA Physicians-in-Training - Online Submission for Subgroups and Suggestions05-28-20200007
2452019 Southern Region Burn Conference - Abstract Presentation Confirmation (1)08-19-20200000
2462020 Southern Regional Assembly Poster Presentation Confirmation08-19-2020000104
2502021 Call for Abstracts - Physicians-in-Training Leadership Conference08-24-202000091
262Southern Region Burn Conference 2020 - Meeting Evaluation and Attendance11-06-20200000
265Moreton Nomination Form01-14-2021102021
268~Leadership Application01-26-2021912739
2692021 SMA Annual Scientific Assembly - Participation Confirmation02-02-20210000
2772019 Emerging Issues - Evaluation and Attendance (1)03-15-20210000
2782021 Comparative Healthcare Systems03-15-202100018
2812020 Burn Conference Call for Abstracts (1)04-12-20210000
2822021 Burn Conference Call for Abstracts 04-12-20210000
2832021 Burn Conference Call for Abstracts04-12-2021000134
2882021 Annual Scientific Assembly - Call for Abstracts04-27-2021000133
2892021 Medical Student Scholarship Application05-13-202100019
290PIT Scholarship Improvement Survey05-24-202100026
2982019 Alabama Healthcare Fraud Summit (1)07-16-20210000
301Airway Workshop for the Non-Anesthesiologist - 07/31/202107-20-202100020
3042022 Call for Abstracts - Physicians-in-Training Leadership Conference08-06-20210000
3052022 Call for Abstracts - 2nd Annual Physicians-in-Training Leadership Conference08-09-2021000125
3062021 Southern Region Burn Conference - Abstract Presentation Confirmation08-23-20210000
3072021 Southern Region Burn Conference - Abstract Presentation Confirmation08-24-20210000
309Workshop on the Difficult Airway - 06/26/2021 (1)10-08-20210000
3102023 Up North Conference 10.14.2310-18-202100028
313Southern Region Burn Conference 2021 - Meeting Evaluation and Attendance10-21-2021000213
315Application - Physicians-in-Training Mentoring Program 202211-03-202100036
3172022 PIT Conference - Live Presentation Workshop11-16-20210001
320Universal Member Registration12-28-2021127510138544887
3212021 Updates in General Internal Medicine01-12-202200015
323SMA PIT 2022 Mentoring Program - Survey01-31-202200025
3242022 Annual Scientific Assembly - Call for Abstracts02-03-202200097
3252022 Mentoring Agreement Form02-03-202200024
328Common Osteoarthritic Conditions of the Hand: Diagnosis and Management02-08-202200015
3292022 - SMA PIT Leadership Conference - Meeting Evaluation and Attendance02-21-202200053
330SMA PIT Mentoring Program - Evaluation02-28-202200012
3332022 - Auburn University PEMBA Spain Global Learning Experience03-10-20220009
334Southern Sleep Society 44th Annual Meeting04-07-2022000106
3372022 Southern Region Burn Call for Abstracts04-22-2022000126
3382022 SMA Annual Scientific Assembly RSVP04-22-202200013
3392022-23 SMA Call to Committee04-22-20220003
3402022-23 Committee Chair Nominations - USE VOTING SYSTEM05-04-202200012
341SMA Medical Student Scholarship Application05-06-202200040
343Diagnosis and Treatment of Common Minor Hand Emergencies: What Every Primary Care Physician Would Like to Know (5/10/2022)05-11-202200013
349Strategically Managing Health Care Policy - Meeting Evaluation and Attendance - 6.12.202206-06-202200024
350The World Health Organization (WHO) 2021 Guideline for the Pharmacological Treatment of Hypertension in the Adult: Clinical Implications (6.14.2022)06-08-202200018
351Standardized and Simple Pharmacologic Treatment Protocols: A Critical Component of Hypertension Control (6.15.2022)06-09-20220009
3522022 - PIT SMArt Bowl06-10-20220004
354Critical Drivers of Hypertension Control (6.29.2022)06-24-20220007
358Chronic Kidney Disease: Screening and Early Management (7.27.2022)07-20-20220002
3592023 Physicians-in-Training Leadership Conference - Call for Abstracts07-29-2022000119
363Standardized and Simple Pharmacologic Treatment Protocols: A Critical Component of Hypertension Control (8.24.2022)08-04-202200018
364Artificial Intelligence in Critical Care Medicine (8.9.2022)08-10-20220002
3652022 - PIT SMArt Bowl - Individual Entry08-18-20220000
367CVD Risk Assessment and Monitoring (9.7.2022)08-30-202200016
371Critical Drivers of Hypertension Control (9.21.2022)09-22-202200017
3722022 Alabama Healthcare Fraud Summit - Evaluation and Credit09-30-202200019
373Diabetes, Hypertension, and Chronic Disease Paradigm (10.5.2022)10-10-202200013
374Alignment and Cohesion with National Best Practices (10.19.2022)10-18-202200018
377Southern Region Burn Conference 2022 - Meeting Evaluation and Attendance10-26-2022000198
3822022 Biennial Breast Imaging Conference11-04-2022000159
3832023 Physicians-in-Training Leadership Conference - Call for Abstracts (1)11-21-20220000
385SMAs Virtual Abstract Competition 202312-05-2022000118
3942023 PIT Conference Exhibitor Registration01-25-20230000
395Airway Management Workshop and Update (02.04.23)02-14-202300011
397Comparative Healthcare Systems - Global Experience: Lisbon, Portugal & Brussels, Belgium02-20-202300015
399Donation Form02-20-2023417734
4002023 - SMA PIT Leadership Conference - Meeting Evaluation and Attendance02-28-202300052
4022023 Southern Region Burn Call for Abstracts03-22-2023000122
407A Clinician's Prescription for Well-Being04-10-202300014
408Ultrasound for Aesthetics (04.15.23)04-24-20230009
409The Physician Shortages: Complex Causes and Some Complex Solutions for a Complex Problem (5/9/23)05-02-202300015
412~Scholarship Application05-23-20231086382253
414Public Profile Form06-01-202306140
4152023 Updates in GIM: Pickles, Waterfalls, and More (6/13/23)06-05-202300014
417Learn More About Southern Medical Legacy06-26-20232003
418Use of the Subcutaneous Route for Parenteral Administration of Fluids, Nutrients, and Medications (7/11/23)07-06-202300012
4202024 SMA PIT Conference Call for Abstracts08-17-202300081
4212023 SMA Legacy Gala Ticket08-17-20230008
423Zoom Registration08-21-20230001
426~CME Application ARCHIVED July 202609-01-20232927662
427PIT Mentor Application09-16-20230044
4282023 Legacy Gala RSVP09-21-2023000123
4292023 SMA Legacy Gala VAC PLUS ONE Ticket09-25-20230000
4302023 SMA Legacy Gala VAC PLUS ONE Ticket (1)09-25-20230000
431Ultrasound for Aesthetics 05202310-02-20230006
432MRS Centennial Gala and Conference (1)10-04-20230000
434SMA 115th Annual Scientific Assembly 2023 - Meeting Evaluation and Attendance 10.202310-07-2023200137
435One Day Tear Trough Course Cadaver and Ultrasound 7.22.2310-10-20230000
436NeuroCon Live Seminar 07.2829.2310-10-20230000
437Southern Region Burn Conference 2023 - Meeting Evaluation and Attendance10-12-2023100207
438Physicians-In-Training Travel Grant Application:10-12-20230033
4402023 Orlando Colorectal Congress11-28-202300035
441Med Global Annual Conference11-29-202300044
4422023 Orlando Colorectal Congress (1)12-06-20230000
4452023 Orlando Colorectal Congress - REVISED12-11-20230000
450~Disclosures and Conflict of Interest Resolution12-28-2023134293299726
457Custom List Test01-17-20246006
4582024 SMA VAC - Call for Abstracts01-26-2024960096
459Essentials of Psychotherapy02-08-2024450045
4612024 Southern Region Burn Call for Abstracts02-19-202412600126
462~Eval-Quiz-Certificate-OLD02-22-20240101
4632024 - SMA PIT Leadership Conference - Meeting Evaluation and Attendance02-27-20240000
467J-NEW-Exploring Communication about Fall Risk and Prevention between Internal Medicine Residents and Geriatric Patients: A Needs Assessment03-28-20242002
469J-Real-World Evaluation of a Chest Pain Digital Triage Platform at the Point of Care04-10-20240101
472LJP-Physicians Executive MBA - International Study Trip to South Africa04-12-20244004
473EM-Alcohol Use Disorders and Associated Cirrhosis: Current Trends, Approach, and Management04-15-20240202
474~Joint Provider WORKING ON THIS04-15-20240000
477EM-Addiction in the South: Overcoming Disparities and Challenges04-21-20243508
478LJP-Anesthesia Scholarly Connections04-30-20245005
479EM-Substance Use Disorders: Treatment and Policy05-20-202429011
480SMArt Bowl Questions05-29-2024337040
481LJP-Ultrasound for Aesthetics05-29-2024120012
482LJP-Parker Seminars Las Vegas05-30-20240000
483LJP-PEMBA Silver Anniversary Reunion – Current Issues in Healthcare Leadership05-30-2024200020
484~Content Procurement and Validity05-31-2024715527
485LJP-PEMBA Class of 2025 – Healthcare Policy Residency – Washington, DC – June 202406-04-2024180018
486SMArt Bowl - Team Registration Form06-11-202456011
487Simple Payment Form06-21-20240000
488J-Comprehensive Care for Adults with Down Syndrome in Primary Care Settings06-22-20243205
489J-Opioid Use Disorder among Hospitalized Adults in North Carolina: Analysis from the 2000–2020 NC State Inpatient Database06-22-20240101
491LJP-Epiphany Dermatology Annual Retreat 202406-25-2024451046
492LD-Misery is Optional06-26-20240000
493J-Patient Retention in a Substance Use Disorder Telemedicine Clinic07-03-20240101
494J-Effects of Preoperative COVID-19 Status on Emergent or Urgent Colectomy Outcomes07-04-20240202
495LJP-Ultrasound for Aesthetics 207-22-2024100010
496LJP-Ultrasound for Aesthetics (May 2024)07-24-20249009
497LJP-Ultrasound for Aesthetics (July 20 2024)07-30-20244004
498LJP-Ultrasound for Aesthetics (September 28 2024)08-07-20243003
501LD-Navigating Scope of Practice Tensions08-16-20243003
5022024 Southern Region Burn Conference - Evaluation and Attendance08-21-202415710158
5042025 PIT Call for Abstracts08-22-2024740074
5052024 Assembly Survey08-23-20242002
506~Direct CME Activities08-29-2024130013
509LD-Eosinophilic Esophagitis in Children and Adults09-17-20247007
510Understanding Hypertension Sample Course09-20-2024130013
511LD-Sports Medicine Talk on Hand & Upper Extremity Part I09-27-2024150015
51337th Annual SRBC ABS MOC Self Assessment10-03-20243003
514MedGlobal Annual Conference - October 202410-05-2024143017
5152025 Burn Attendee Registration10-09-20240202
5162025 Burn - Call for Abstracts10-10-20240000
5172025 PIT Attendee Registration - OLD10-16-20248008
5182025 Virtual Abstract Competition - Call For Abstracts10-17-2024079079
5192025 Virtual Abstract Competition Event Registration10-17-20240000
5202025 ASA Attendee Registration10-17-20240707
521PIT Mentee Application10-28-20240099
5232024 ASA Activity Evaluation10-28-2024332035
524Assessment and Management of Patients with Pain and Substance Use Disorders11-14-20240707
525L-Demystifying Dementia11-15-20245005
526Screening/Treatment of Alcohol Use Disorders in Non-Specialty Healthcare Settings11-18-20240808
527Neurobiology of Addiction11-19-2024011011
528Treatment of Opioid Use Disorder/Overview of Substance Use Disorder Treatment11-19-2024014014
5292025 Burn - Exhibitor Registration11-20-2024831039
530E-Demystifying Dementia12-02-20240303
5312025 ASA Exhibitor Registration12-04-20240707
532Emerging Insights in Biology and Treatment Approaches to PTCL - December 202412-09-20242002
534stripe test12-12-20240000
536LD-Sports Medicine Talk on Hand and Upper Extremity Part II12-12-20249009
5372025 PIT Exhibitor Registration12-16-20242002
5392025 PIT Attendee Registration12-17-2024566071
5402025 Southern Region Burn Call for Abstracts01-22-202501340134
541LJP-Emerging insights in biology and treatment approaches to Peripheral T cell Lymphomas (PTCL)01-23-20250606
542User Profile Update Test01-29-20250000
543Board Assembly Survey03-02-20250000
544E-Part I: Sports Medicine Talk on Hand and Upper Extremity03-02-20250000
5452025 Hypertension Summit - Attendee Registration03-03-20250101
5462025 Hypertension Summit - Exhibitor Registration03-03-20250202
5472025 SERUCA Call for Abstracts03-20-20250303
548LJP - Global Health Care Systems: Comparative Analysis of the US, Chile and Argentina03-27-2025011011
549CQH: Billing and Coding03-31-20250000
551LJP-Strategically Managing Health Care Policy (March 10-14, 2025)04-09-20250000
552B-Certified CME (April 12 2025)04-11-2025017219
553IMG – Self-Identification & Interest Form05-02-20250044
554E-Skin Cancer SMC #105-14-20250404
555LJP-AU-Strategically Managing Health Care Policy (June 8-10)06-03-20250606
556LJP-Thriving Together – Epiphany Dermatology 202506-15-2025039039
557E-NCMB Opioid Prescribing Update06-25-20250505
558Content/Activity Development06-26-20250000
559VJP-Strategically Managing Health Care Policy (July 14-18, 2025)07-11-20250000
560EJP-Epiphany Dermatology – Thriving Together – Enduring07-29-20250000
561LJP-Parker University NeuroCon08-08-20250000
562IMG Fellowship Forward – Mentee Application08-14-20250055
563IMG Fellowship Forward – Mentor Application08-14-20250022
564Contact Us08-16-20250108101081
565BURN ASSESSMENT TEST08-22-20250000
56624710 - 2025 Southern Region Burn Conference - Evaluation and Attendance08-24-202501720172
568Renewals (1)09-19-20250000
569MedGlobal Annual Conference - October 2024 (1)09-19-20250000
570survey test09-19-20250000
5712025 SRBC Preconference Assessment09-20-20250000
572E-Precon Sculpting Recovery and Restoring Function: Casting and Compression in Burn Rehabilitation09-23-2025022022
573Executive Director Performance Evaluation09-29-20250808
5742025 SRBC Preconference Assessment Quiz Version09-30-20250202
575Preassessment: Sculpting Recovery and Restoring Function: Casting and Compression in Burn Rehabilitation10-01-2025025025
576IMG Clinical Observership – Mentee Application10-02-20250000
577IMG Clinical Observership – Mentor Application10-02-20250000
57924337- The 3rd Annual Santa Monica Melanoma Symposium10-02-20250808
58023123-Diabetes Summit Webinar10-03-20250212344
581Donation Form (1)10-09-20250000
58224578 - 2025 Pediatric Burn Program10-11-2025020020
58324289 - MedGlobal Conference and Gala: Health in a Turbulent World10-20-2025019322
58424579 - 2025 Burn Rehabilitation Workshop10-22-2025019019
585OLD-DON'T USE Whole Person Health Attestation10-23-20250202
5862025 SMA Annual Scientific Assembly: Pain Management Session10-30-2025027128
5872026 Virtual Abstract Competition - Call For Abstracts11-06-2025005656
5882026 PIT Attendee Registration11-06-2025005656
5892026 PIT Call for Abstracts11-06-2025084351
5902026 PIT Exhibitor Registration11-06-20250011
59122418 - 2025 SMA Annual Scientific Assembly: Advancing Oncology Care and Prevention11-08-2025035136
59323278-Eudēmonia Summit11-13-2025030333
59424758 - 2026 Burn Call for Abstracts11-18-202500136136
59624339 - 39th Clinical Applications for Age Management Medicine11-20-20250651277
598Speaker Experience Feedback12-01-20250303
599Help Shape the 2026 SMA Assembly!12-04-20250101
600Service History12-05-20250000
603E-26703-Preassessment: 2025 Annual Scientific Assembly: Pain Management Session12-27-2025016521
604E-26703-Attestation 2025 Annual Scientific Assembly: Pain Management Session12-27-20250145
6052025 PIT Exhibitor Registration (1)01-09-20260000
606Doctor's Day Card Generator01-15-2026001515
608Quality Improvement Attestation01-23-20260011
611Interest in Leadership Course Survey02-02-20260033
612Member Interest - Text Communications02-03-2026001010
61424350 - AOE - LD -The 6th Annual Chief Residents Summit on Obesity02-19-2026002828
615Leadership Report Form02-20-2026001616
61624766 - AOE - ED -The 6th Annual Chief Residents Summit on Obesity (CRSO) Webinar Series02-21-2026001111
617TEST EVAL with new questions02-26-20260000
6182026 Moreton Nomination Form02-26-20260044
619Medical Student Membership Survey03-04-20260000
62024659 - ED - Groin and Pelvic Hernias: The Master Course03-21-20260011
6212026 Lung Ultrasound for Everyday Practice Webinar Survey03-23-20260088
62227497-March 2026-CQH-RSS-ECHO Series-DM MGT03-24-20260077
623test03-24-20260033
62527497-January 2026-CQH-RSS-ECHO Series-2025 AHA/ACC Guidelines03-29-20260022
62627497-February 2026-CQH-RSS-ECHO Series-CHANGE Program Findings and Impact03-29-20260022
62727497-April 2026-CQH-RSS-ECHO Series-Holistic Women’s Heart Programs03-29-2026001111
62827497-May 2026-CQH-RSS-ECHO Series-Maternal Cardiac Program03-29-20260088
62927497-June 2026-CQH-RSS-ECHO Series-Addressing Community-Level Strategies03-29-2026001212
63027497-July 2026-CQH-RSS-ECHO Series-Barbershop-Facilitated Community-to-Clinic Linkage03-29-2026001515
631~~REVISED Enduring Eval Template04-02-20260000
632~~REVISED Live Eval Template04-02-20260000
6342026 POCUS Survey04-27-2026002121
63528189-Enduring-Whole Person Health Post-Activity Evaluation and Competency Assessment04-27-2026001616
63628189-Enduring-Whole Person Health Pre-Activity Assessment04-28-2026001111
63828214-Enduring-Quality Improvement Post-Activity Evaluation and Competency Assessment05-11-20260000
63923384 - Live - Healing in Practice05-12-20260044
640Pre Assessment Template05-13-2026001515
641Post Assessment Template05-13-20260088
64227751 - Live - Ethical Implications for AI in Healthcare05-19-2026002323
64328214-Enduring-QI Pre-Activity Assessment05-25-2026001111
64428214-Enduring-QI Post-Activity Evaluation and Competency Assessment05-25-20260055
6452026 MSC Abstract Submission06-10-20260077
646A-19 Content Re-Release06-11-20260011
647Assembly Interest Survey06-23-20260077
649SMA Newsletter Submission07-02-20260000
650CV Application Review07-06-20260000
651Fellowship Forward Course Evaluation07-13-20260088
6522026 Virtual Abstract Competition - Call For Abstracts Payment Form07-14-2026004949
653A7 - Clinical Content Review Form07-15-20260000
65424758 - 2026 Southern Region Burn Conference - Evaluation and Attendance07-20-20260000
655A2 - Education Partner Attestation07-24-20260011
656A3 - Education Partnership Agreement07-24-20260000
657Profile08-07-2026001111
658Password Reset08-07-20260000
66128380 - 2026 Southern Region Burn Pediatric Program08-17-20260000