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.