Please fill in these fields if you intend to use this course for National Registry of Emergency Medical Technicians (NREMT) continuing education unit (CEU) credit with the Commission on Accreditation of Pre-Hospital Continuing Education (CAPCE). If you wish to receive 1.5 CEU credits for this course, please fill out all of the information listed above. If you do not wish to receive CEU credit, simply click “continue.” <br> <br> If you are seeking CEU credit, by completing the form, you agree to the following: I understand that SAMHSA and IQ Solutions, as a requirement of CAPCE accreditation, will submit a record of my course completions to the CAPCE AMS. I further understand that my course completion records may be accessed by or shared with such regulators as state EMS offices, training officers, and NREM on a password-protected, need-to-know basis. In addition, I understand that I may review my record of CAPCE-accredited course completions by contacting CAPCE.
E-mail:
First Name:
Last Name:
Phone:
Address (Line 1):
City:
State / Province:
Zip / Postal Code:
NREMT License Number (if applicable):
NREMT Re-certificate Date (if applicable):
Type of Professional License (EMT/Paramedic/Etc):
Professional License Number:
Professional License Expiration Date:
State in Which Professional License is Valid:
Middle Initial of License Holder: