1) Pre-Planning Worksheet

Pre-Planning Worksheet

After submitting the worksheet below, a representative from our office will contact you to explore the idea further. Thanks for your interest in CECentral!

Activity Director

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Affiliation

Funding Source

Activity Details

Topic/Purpose/Description

Target Reach

Will this activity offer education for 2 or more professions?

Target Audience

Activity Format

Number of Speakers

Why is this education needed?

0/500

What would the training change in the participants' skills/strategy, or performance or patient outcomes?

0/500

What outcomes would result from the above changes in skills/strategy, or performance or patient outcomes?

0/500

Estimated Date of Activity

Tell us when you think the activity will be held

CECentral Contact