Personal Information - *SMART The Webinar

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Personal Information

Fill out the information below, then click Next to continue.

*

Registration Type

This question is required.

* First name

* Last name

* Credentials

* Email address

* Mobile | This number is only used for registration purposes and will not be distributed.

* National Provider Identifier (NPI) Enter 0000000000 if not applicable.

* School | Team | Club | Organization Name

Title

*

Do you plan to claim CME for this program?

This question is required.

Yes
No

This activity is now accredited through The American Academy of Pediatrics. In order to receive a certificate and access your transcripts, you must set up an account on https://www.aap.org and enter your AAP ID number below.

How to Create an AAP Account

If you already have an AAP account, you can simply enter your existing AAP ID below.

*

Do you require Chiropractic CEUs for this educational activity?

This question is required.

Yes
No

Work Address

* Address 1

Address 2

* Country/Region

USA

* City

* State/Province

* ZIP/Postal code

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