Ampcare CE Course Host Information

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Last

Email

Phone

Address

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City

State

Zip Code

Scope of Patient Types (check all that apply)

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Potential other Scope

Facility Types (Where do you see patients?)

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How many SLPs would be interested in this training from your group?

Would you be willing to allow others from outside your company to attend?

Any additional details you feel are necessary to your inquiry?

Potential Date/Time-frame/Format for Hosting

We offer the live/in-person training in 2 formats: 2-hours of online content + 8-hours in-person or 6-hours of online content + 4-hours of in-person.

How did you hear about us?

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