Continuing Education Form - CEU's
Fill the form below accurately.
Name:
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Which video did you watch ?
*
Name three things you learned from watching this video.
*
Please complete this submission form and include enough detail in your response to show that you watched the entire video and provide details of three facts you learned while watching it.
Complete this form for each video you complete.
Your submission form will be submitted to the Management Team at Acadia Care Group who will ensure you get your CEU credit.
Date
*
-
Month
-
Day
Year
Date
Provider Signature
*
Should be Empty: