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* 1. Please provide the following.

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* 2. I hold a MD or DO:

I claim _____ AMA PRA Category 1 credit(s) ™ for participating as a learner in this activity (1 credit for each hour of participation, not to exceed 16 credits). If you attended the entire workshop, enter 16 credits.

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* 3. If you are not an EMS Physician, what is your medical specialty?

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* 4. Is this the first time you will be taking the exam?

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