Please complete the form below to confirm that you have finished the course in its entirety and to receive your CE credits/units.

Please enable JavaScript in your browser to complete this form.

Full Statement Name

Attestation Statement *

• I attest that I have completed the “Redefining Healthcare Course” in its entirety and request an official certificate of completion. I understand that if I reside in a state where CE Broker reporting is applicable, my credits will be reported electronically. Otherwise, it is my responsibility to self-report my credits by submitting my certificate of completion to my state board.

Full Name *

License Number *

Email *

Email

Confirm Email

Date / Time *

Date

Time

Legal *

• I hereby agree and attest to the accuracy and truthfulness of the information provided.

Submit