Complete this Attestation Form if you are a Certified physician seeking credit under Maintenance of Certification for Performance in Practice. To be eligible for credit, you must have satisfied all requirements for meaningful participation, as defined in your project.
After you complete this attestation form, it will be submitted to the Ohio AAP program manager for your project, who will ensure the signature of your project’s Local Leader or the QI Project Leader (depending on how your project is organized) is received. The Ohio AAP will then forward completion documentation to the correct board so that you can receive credit for MOC. Credit is submitted approximately once per month, unless a physician indicates the need for expedited processing. The proper board will only receive documentation of your successful completion of the project and identifying information to ensure your record is accurately updated.