CPCSSN Quality Assurance Program
Submission form for Mainpro-C credits

This form documents how you used your experience with the CPCSSN chronic disease profile of your practice to critically reflect on your management of one of the chronic diseases that are under surveillance in your practice by CPCSSN. The QA activity may or may not have included a comparison with other local or national practices.
  • You will receive 3 Mainpro-C credits for each of these forms you submit.
  • You may submit a form once a year for each of the chronic disease under surveillance in your practice by CPCSSN providing a profile of
    your practice of the chronic disease patients that has been created for you by the CPCSSN Database Manager.
  • Once you have completed this form, mail or fax it to the College to obtain your Mainpro-C credits.
  • MainPro-C credits have been pre-approved for the CPCSSN project providing the form is completed and submitted

Check the chronic disease under surveillance by CPCSSN in your practice for which you received a profile of your practice.

Did you compare your practice with others or was it a review of your practice alone without comparison?

(Including participating in a presentation of the profile by a CPCSSN staff person, personally reviewing the data, making changes to alter your approach to management of the chronic disease, discussion with colleagues, reflecting on the results, the changes to be made, and the effect of the changes on your practice.)