Submit Your Recent Meeting Documents and Pictures

DPLN meeting documents need to be submitted to AADOM national within two business days after the event, including in-person sign-in sheet(s) and/or virtual attendee report, Affidavit of Image Authenticity form, and Declaration of Conflict of Interest form. Upon receipt of the documents, AADOM national will apply AADOM CE to all active national members and will record all meeting forms and information for AGD audit and review. AGD/PACE CE certificates are provided to attendees by the hosting DPLN. Please note: Beginning September 1, 2022, if all documents are not submitted to AADOM National within 7 days of the chapter meeting, the DPLN will be placed on hold and the approved DPLN status suspended until all DPLN meeting documents have been submitted.

Post-DPLN Meeting Documents & Pictures Submission Form
DPLN Name*
Your Name*
First Last
Email*
What is your role in the DPLN?*
Date of the meeting*
MM slash DD slash YYYY
Was this a co-hosted meeting with another AADOM DPLN?*
- No
- Yes
If yes to the previous question, are you submitting all documents and pictures (if applicable) for this event?
- No
- Yes
If this was a co-hosted meeting, please provide the name of the co-hosting AADOM DPLN::
Please upload sign-in sheets and/or attendee reports.
Drop files here or

Accepted file types: pdf, jpg, png, xlsx, docx, Max. file size: 9 GB.
Please upload Affidavit of Image Authenticity Document(s).
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 9 GB.
Please upload Conflict of Interest Declaration Document(s).
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 9 GB.
If applicable, please upload pictures of your event for social media posts. (limit of 7)
Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 9 GB.
CAPTCHA