Customized Ed Session


Education Session: Request Form

Important Information
Request a Customized Education Session: Choose the date, time, and topic of your choice!

Please Note:
  • Maximum: Two (2) custom sessions per clinic/per calendar month.
  • All Ed Session requests must be submitted at least 4 weeks prior to the session date.
  • All sessions are 60 minutes and hosted on the Zoom webinar platform.
  • Please submit a request form for each individual topic or session.

General Information

Ex.MDs, NPs, Residents, Variety of all Medical Staff, etc.

Date & Time Selection

Please provide your clinic's ideal date and time for this Education Session request.  If your clinic is flexible on your date and/or time availability, you can provide up to 2 alternative dates and/or times.  Providing additional date/times increases our ability to accommodate your requests.




Please use this space to share any questions or thoughts. Ex. I would like to schedule a reoccurring session for the First Wednesday of every month.

Topic Selection

Please select your topic(s) of interest. 

Choosing at least one specialty will reveal the session titles for each area.  

If your clinic requires an education session before 10:00am EST, please select topics with an "*".

Thank you for completing the Custom Education Session Request Form.  Our Program Coordinator will respond to your request within the next 3 business days.