LECOM Preceptor Training: Curriculum and Clinical Pearls Demographics Participant demographics: Question Title * 1. Full Name: Question Title * 2. Please indicate credentials Physician-MD/DO PA/ARNP Other Other (please specify) Question Title * 3. What type of certificate do you wish? CE Broker reporting only; no certificate needed Electronic Paper E-mail or physical address to send certificate Question Title * 4. Florida license number for CE Broker reporting: Question Title * 5. How many credit(s) are you claiming: 0.50 0.75 1.00 (maximum) Other (please specify) Question Title * 6. I attest that I have watched the Curriculum and Clinical Pearls webcast video. Yes No If no, please explain. Next