DaneGarvin.com - HIV

P.A.C.E. Credit Application

P.A.C.E. Program #015-776-09

Integrase Inhibitor Drug Resistance in Clinical Practice

Original Live Web Conference:
November 3, 2009

Archived Web Conference:
Release Date: December 31, 2009
Expiration Date: December 31, 2010

At the end of the application process you will be provided with a "Session Code" for this P.A.C.E. accredited program. Make note of this number. You will need it to generate your online P.A.C.E. certificate for attending this program. Follow the instructions provided at the end of the Evaluation Form.

To receive P.A.C.E. credit for attending, please complete the following form.

Fields marked with * are required.

Send me notification of future events:
First Name:*
Last Name:*
Address:*
City:*
State:*
Zip:*
Country:*
Phone:*
Email Address:*
Confirm Email Address:*

Institution:
ASCLS Member Number:
State License Number:
Web Address:

By completing this form, I attest that I participated in the full instructional time for the program.

You may also print this form and mail to:
Dane Garvin Ltd.
1909 Dewes Street, Suite 1E
Glenview, Illinois 60025
USA

Or you may Contact Us for further assistance.