NCPDP Webinar "Perfecting ePrescribing"
ACPE UAN 0459-0000-18-041-H04 Contact Hours / 0.15 CEU Release Date - April 26, 2018

Participant Information

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* 1. First Name

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* 2. Last Name

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* 3. What is your CPEMonitor e-Profile number. (Need more information, go to www.nabp.net)
If you do not wish to claim credit, please enter 123456.

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* 4. Choose the number that represents your Birth Month

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* 5. Choose the number that represents your Birth Date

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* 6. Profession of Participant

Pharmacist

Pharmacy Technician

Intern / Student

Other

Other (please specify)

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* 7. Email Address

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* 8. Contact Information

Street Address

City

State

ZIP Code

Phone Number