subject_line

Maintenance of Certification Program

at Baylor College of Medicine

QI Activity Sign-Up Form

Activity Title: Improving Primary Care Clinician Screening

for Primary Hyperparathyroidism in Patients with Hypercalcemia

This form should be used by eligible physicians/physician assistants

to request to participate in the noted QI Activity.

Requests may take approximately 5 - 7 business days after the conclusion of the activity sign-up period to process, and at which point, project participants will be contacted by email with project details and instructions.

For assistance, contact: BCM MOC Program

Registration Deadline

Department of Family and Community Medicine

Deadline - Extended: Wednesday, February 19, 2025 @ 11:59 PM

QI Activity

QI Activity Title
I am requesting to participate in the following QI Activity: *

Improving Primary Care Clinician Screening for Primary Hyperparathyroidism in Patients with Hypercalcemia

This QI Activity is open to Baylor Medicine primary care clinicians in the following departments:

- Department of Family and Community Medicine

- Department of Medicine - Section of General Internal Medicine

Requestor

Profession *

Physician

Physician Assistant

Prefix *

Dr.

Mr.

Ms.

First Name *

Last Name *

Professional Category/Degree(s): (select all that apply) *

MD - In Practice

MD - Fellow

DO - In Practice

DO - Fellow

PA, PA-C

PhD

PsyD

EdD

DrPH

MBA

MHA

MPH

Other (please specify) Other (please specify)

Current BCM/BCM-Affiliated Employee? *

Yes

This QI Activity is open to current BCM employees in the institution and departments indicated above.

For assistance, contact: BCM MOC Program

Activity Enrollment Info

This following information is required to process your enrollment in the Activity Portal for this QI Activity:

BCM Email *

BCM ECA (BCM username) * 🛈

BCM Employee ID (6-digit number) *

Institution, Department, Project Lead

Primary Institution *

Baylor Medicine

Department (@ Primary Institution) *

Medicine - Section of General Internal Medicine (GIM)

Family and Community Medicine (FCM)

Project Lead (FCM) *

Malvika Juneja, MD (Email: juneja@bcm.edu)

Project Lead (GIM) *

Daniel Murphy, MD, MBA (Email: drmurphy@bcm.edu)

MOC4 - QI Activity Sign-Up Form - Project: Hyperparathyroidism | ver. 20241214