Course registration
Part 1: Introduction and Theory (Internet Live Course)
Sign in to Google to save your progress. Learn more
Name *
Email *
Professional degree *
Do you want continuing medical education (CME) credits for the course? It is recommended that you get CME credits if you plan on using the hours from this course to apply for licensure in a state that has minimum hour requirements or if you plan on becoming board certified in acupuncture.  *
What state do you currently practice in and what state do you anticipate practicing in in the future if different than the above? *
Do you own any of the course textbooks? If so, which one(s)?  *
Required
What is the address you would like your books shipped to?
Myers Anatomy Trains is available as a digital copy or paper copy. Which version do you prefer?
Clear selection
Bleecker Acupuncture Points Handbook is available as a digital copy or paper body. Which version do you prefer?
Clear selection
What is your experience with acupuncture?
I understand that I will have to pay $$ prior to the start of the course. I plan to pay by:  *
Please indicate which parts of the course you plan on attending: *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Chi Tang Acupuncture.

Does this form look suspicious? Report