Please use the following Excel document to share attendee demographic information. The information is used to award continuing education credit and distribute certificates.

Access the template.

The following columns are required and are highlighted green on the document. 

  • Email (A unique email address is required for each person)
  • First name
  • Last name
  • Street
  • City
  • State
  • Postal code
  • Profession (Options are below)
    • DO
    • MD
    • PhD
    • Nurse
    • Nurse Practitioner
    • Physician Assistant
    • DPM
    • Physical Therapist
    • Social Worker
    • Student
    • Resident
    • Other
  • Degree/credentials
  • Specialty