Call: 503/765-7615

Logistics@crisis-medicine.com

Are you an online student who didn’t get to enter your CAPCE information for CEH?

If the Complete Course button is selected before all required steps are finished, the system will lock the course record. This can happen occasionally and is straightforward to resolve.

Please complete this form & we’ll process it just as though you’d filled out the form with your course. Email with any questions, logistics@crisis-medicine.com

Name
Address
Please select the Crisis Medicine course you completed. NOTE the selections are separate courses included in TC2/ATC2/CTC2 so choose the selections only if you did not take a comprehensive course. The course you select will reflect the CEH uploaded to CAPCE so please ensure it is accurate
Please select the state of your medical licensure, EMR, EMT, Paramedic, etc.
Please enter your STATE license number. Entries without the completed information cannot be uploaded to CAPCE.
License Type - per CAPCE only one license type may be credited with each course (so you cannot submit two forms to count CEH for both paramedic & ACP for example).
Please enter the month, day, and year of expiration. Entries without the complete information cannot be uploaded to CAPCE. Example 03/30/2022
Please see https://www.nremt.org/rwd/public/document/news-ems-id-release if you are not familiar with this new recertification number. If you do not have this number, we CAN still award CEH if you complete the information below.
Please enter the month, day, and year of expiration. Entries without the complete information cannot be uploaded to CAPCE. Example 03/30/2022
I understand that Crisis Medicine as a requirement of CAPCE accreditation will submit a record of my course completions to the CAPCE AMS. I further understand that my course completion records may be accessed by or shared with such regulators as state EMS offices, training officers, and NREMT on a password-protected need-to-know basis. In addition, I understand that I may review my record of CAPCE accredited course completions by contacting CAPCE.
By checking this box I affirm that I watched all of the materials, completed the quizzes myself, and in compliance with CAPCE requirements for submitting for continuing education credits, and am entitled to claim credit for this educational program.