PIP Prescriber Training Form

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In order to receive your PIP Certificate, please watch all of the required videos indicated in the playlist (see YouTube link below). When you've completed the required playlist, check off the "Self Declaration" question and hit "send" to submit your training declaration. To print a copy of your training completion, select "send me a copy of my responses" https://www.youtube.com/playlist?list=PLCKtJPkaVpnb9y8NMn5o1fbseA_QXmV3w

Email *

Last Name, First Name *

Self Declaration: I declare I have completed viewing the following required training videos. *

Prescriber Training

Required

Send me a copy of my responses.

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