CE Submission Form

Continuing Education Submission Form

"*" indicates required fields

Name*

Course Information

CE Information (Subject Codes are listed below)*
All details are required, including: subject code (numeric – from list at bottom)
• hours (numeric)
• date (in the proper format of mm/dd/yyyy, i.e. 11/23/2021).
• ENTER START DATE ONLY FOR MULTI-DATE EVENTS, i.e. 11/22/2021.
—>>> “Nov 22-24, 2021”, “11/22-24/2021” ARE NOT VALID DATES <<<---


NOTE: Entries with missing, invalid, or improperly formatted information will be rejected or returned without acceptance
Course Title
Subject Code
Hours
Instructor
Start Date (mm/dd/yyyy)
 

CE record data will be available within 24-48 hours (M-F) after submission and verification.

This field is for validation purposes and should be left unchanged.

Diagnostic

  • 101 Diagnosis
  • 102 Treatment Planning
  • 103 Cephalometrics
  • 104 Radiography
  • 105 Photography
  • 106 Growth & Development
  • 107 Record Keeping
  • 108 Other

Appliances

  • 110 Tip-Edge®
  • 111 Edgewise
  • 112 Straight Wire®
  • 113 Functional/Orthopedic
  • 114 Crozat
  • 115 Controlled Arch®
  • 116 Combination
  • 117 Other

Sciences

  • 120 Basic Sciences
  • 121 Anatomy
  • 122 Microbiology
  • 123 Biochemistry
  • 124 Kinesiology
  • 125 Nutrition
  • 126 Materials
  • 127 Physiology
  • 128 Pharmacology
  • 129 Other

Related Codes

  • 130 Branding/Bracketing
  • 131 Occlusion
  • 132 Myofunctional Therapy
  • 133 TMJ/TMD Therapy
  • 134 Surgical Orthodontics
  • 135 Gnathology
  • 136 Anesthesia & Pain Control
  • 137 Practice Management
  • 138 Teaching
  • 139 Authorship
  • 140 Other

HABLA ESPAÑOL

PARLE FRANÇAIS