Please enter the information below to receive CAPCE credit. You will need to enter at least a state or NREMT for credit, please enter both if you have them. You will receive a separate email from Prodigy EMS with instructions on accessing your certificate. 

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. City of Residence

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* 5. State

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* 6. Provider Level

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* 7. State License Expiration Date

Date

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* 8. NREMT Certification Number

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* 9. NREMT Expiration Date

Date
By submitting this form, you agree that you participated in this course and the information above is accurate.
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