CE Attendance Log
This form is only for those who intend to receive Continuing Education (CE) credit for participating in the 2019 Total Tox Course.

If you do not intend on receiving CE credit, you do not need to fill out this form.

To receive CE credit, fill out the form and certify your attendance by identifying your arrival and departure times for each day. If you do not complete and submit this form, you will not receive CE.

Physicians should claim only the credit commensurate with the extent of their participation in the activity.

If you have questions, contact ACMT Staff at adrienne.dunavin@acmt.net.
Sign in to Google to save your progress. Learn more
First Name *
Middle Initial
Last Name *
Email *
Which Continuing Ed credits did you purchase? *
Select your highest degree: *
Required
Select your degree category *
Monday, 12/9
ARRIVAL *
DEPARTURE
Tuesday, 12/10
ARRIVAL *
DEPARTURE
Wednesday, 12/11
ARRIVAL *
DEPARTURE
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of The American College of Medical Toxicology. Report Abuse
Google Forms