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AGD CE Submission form
For Dental professionals who want to receive CE credits for their BLS course. This content will be strictly used for entering your certificate into AGD for CE credits.
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* Indicates required question
Email address
*
Your answer
Full Name (First Name/Last Name/Credentials)
*
Your answer
AGD Member ID Number
*
Your answer
Course Completion Date (as shown on CPR certificate)
*
MM
/
DD
/
YYYY
Course Title
*
ProFirstAid Advanced
Pro Pet Hero
ProBloodBorne
Bloodborne for the Workplace
ProPALS
ProPALS Recertification
ProACLS
ProACLS Recertification
ProCPR
Delivery Method
*
Online Only
Course included Hands on skills
Course Location (City, State)
Your answer
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