2021-22 Compliance Education signup

Returning?

A A A

All newly hired MDs, NPs and PAs must complete this mandatory educational requirement within 30 days of hire.

Admin notes:

Expand

Attendance/Attestation:

Expand

First Name*

* must provide value

Last Name*

* must provide value

Title*

* must provide value

Campus Location/Address*

* must provide value

Other*

* must provide value

Department or Practice Name*

* must provide value

Specialty*

* must provide value

Status*

* must provide value

Full Time

Part Time

Per Diem

reset

Date of Hire*

* must provide value

M-D-Y

Life Number*

* must provide value

NPI Number*

* must provide value

Session date you would like to attend.

All sessions start at 8:45 AM and are roughly 3 hours long. All clinical providers are required to complete this mandatory education within 30 days of hire.

* must provide value

Administrator's Name*

* must provide value

YOUR Preferred email address for zoom invite*

* must provide value

Registered by:
(if different from the attendee)

Registered By:
If you would like to receive a copy of the confirmation email or (send a copy to your Admin), please enter email address here.

Are you updating your information or rescheduling?

Yes

reset

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.