IME Application
INDEPENDENT MEDICAL EDUCATION REQUEST FORM
ACCREDITED AND NON-ACCREDITED EDUCATIONAL ACTIVITIES
Grant requests should be submitted to Covis at least 60 days in advance of the scheduled event and must be on institutional letterhead accompanied by an IRS Form W9 (US Only), proof of accreditation: (ACCME, ACPE or other) via certificate and a detailed budget and tentative agenda.
Note: Your application will be reviewed solely based on the scientific merit of the program. An educational grant will not be determined in a manner that takes into account the volume or value of any business otherwise generated with Covis. In addition, an educational grant will not affect the purchase, use, recommending or arranging for the use of any Covis product. Grant funds will not be issued to an individual. The grant and programs described herein should be for scientific and education purposes only and should not promote Covis or its pharmaceutical products, directly or indirectly.
Note: Your application will be reviewed solely based on the scientific merit of the program. An educational grant will not be determined in a manner that takes into account the volume or value of any business otherwise generated with Covis. In addition, an educational grant will not affect the purchase, use, recommending or arranging for the use of any Covis product. Grant funds will not be issued to an individual. The grant and programs described herein should be for scientific and education purposes only and should not promote Covis or its pharmaceutical products, directly or indirectly.