<%If boolOptionListExist = True then%> <%End If%>Donation Requirements for Independent Medical Education<% Public Function GetHeaderImageFromSubPage GetHeaderImageFromSubPage = "" End Function Function GetOptionListPageID GetOptionListPageID = "8163" End Function Function funcGetPublishedPageName funcGetPublishedPageName="popup_additional_reqs_4.html" End Function %> <%If boolOptionListExist = True then%> <%End If%>Requests must be accompanied by a Letter of Request from funding applicant. LOR must include:
- Signed & dated Letter of Request from Requesting Institution on Requesting Institution’s Letterhead
- Letter must be addressed to AmgenMED
- Letter must specify:
- Program Name and Date
- Specific Program Description and Objectives
- Amount Requested
- Statement regarding how funds will be used/budget breakdown
- Letter must include:
- Check Payable to Name
- Complete Address and Telephone Number
- Taxpayer ID Number and provide current W-9 form
- Copy of IRS tax-exempt status determination letter, if applicable
- Identification of Audience (if appropriate)
- Please mail your supporting documents and the printout of the electronic application to:
Amgen
Attn: AmgenMED
One Amgen Center Drive, M/S 36-2-A
Thousand Oaks, CA 91320
OR Fax it to 1-888-758-7776- For any questions regarding the application process or supporting documents please contact 1-866-44AMGEN (1-866-442-6436) between the hours of 8:00 am – 5:00 pm PST
Additional Requirements for Independent Medical Education<% Public Function GetHeaderImageFromSubPage GetHeaderImageFromSubPage = "" End Function Function GetOptionListPageID GetOptionListPageID = "8071" End Function Function funcGetPublishedPageName funcGetPublishedPageName="popup_additional_reqs_4.html" End Function %>To ensure timely review ALL items listed below must be completed and submitted by a Qualified Provider of Independent Medical Education.
Qualified Providers include universities and hospitals, medical societies (e.g. ASCO, ASH, ASHP), and 3rd party qualified provider of Independent Medical Education with sufficient accrediting standards: ACCME Eligibility Criteria
- If an accredited program, the Letter of Request MUST be submitted from the accrediting institution.
- The Letter of Request must state the name of the accrediting body and types of credits offered
- If different accrediting bodies, a letter from each accrediting body is required
- Letter must include a needs assessment that explains the unmet educational need and how the grant will address the unmet need.
- Audience must be identified
- Educational objectives stated
- Agenda (draft acceptable)
- Itemized Budget Requirements (eg, honoraria, travel [include lodging, meals, ground transportation], accreditation fees, program development, deliverables, and other costs associated with the program such as postage/shipping for meeting materials, administrative expenses, etc.). Attached Budget Template is required for all Independent Medical Education requests greater than $15,000.00. Budget Instructions
- A complete reconciliation will be required 60 days after the completion of all Independent Medical Education initiatives. Reconciliation Instructions
- Identification of a 3rd party qualified provider of Independent Medical Education
- Statement if the program is single- or multi-sponsored
- The above requirements are applicable to IME presentations as well as publications or other enduring materials.
- Any requests regarding proceedings from a meeting or congress (e.g., ASH Highlights, ASCO Highlights) need to be received at least 60 days prior to the actual meeting date.
- For Independent Medical Education presentations (e.g. Grand Rounds, symposia), Amgen will only support those programs that are open to healthcare professionals from outside the sponsoring institution (including physicians with visiting privileges).
- Medical Education providers must certify that they are not ‘commercial interest’ as defined by ACCME. Completion of the Certification of Separation is required. Click to Download Certification of Separation.