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Application for Providers of Lifelong Learning Self Assessment/Maintenance of Certification (LLSA/MOC) activities

This application should be completed and submitted to the ABPM for any conference/course that is looking to offer LLSA/MOC credits. The application and supporting documentation should be submitted by the provider of the conference/course. The application and supporting documentation can be submitted by email, fax, or mail (see below for contact information). Once an application is submitted, it takes approximately 4-6 weeks to be reviewed for approval.

LLSA/MOC Application Form

Submit applications by:
Email to Clare Bonnema
Fax to 312-939-2218
Mail to
111 W Jackson Blvd, Suite 1340
Chicago, IL 60604