Continuing Education Request Form Registrant Information Thank you for your interest in Continuing Education information at Animal Emergency & Specialty Center. If you should have any questions, please do not hesitate to reach out to our team. Name(Required) First Last Your Role at the Practice(Required) Email(Required) Contact Phone NumberEvent InformationLunch & Learn Topic ECG interpretation Local anesthetic techniques ETCO2 monitoring Reading blood smears Using continuous glucose monitors Caring for Parvovirus patients Medical Calculations Emergency Triage Stabilizing Shock Other Other (please enter your topic suggestions) Days your practice is typically available for CE (select all that apply) Monday Tuesday Wednesday Thursday Friday Saturday Time of day preferred (select all that apply): Morning (before 12pm) Afternoon (12-2pm) Early Evening (2-5pm) Late Evening (5-9pm) Availability ExplainedCompany/Practice Name(Required) CAPTCHA