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Basic Info
First Name
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Last Name
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Full Name
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This is used on your certificate.
Email Address
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Password
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must contain at least 8 characters
User Profile
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indicates required field
Degree(s):
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What is your profession?
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Certified Nurse Midwife
Certified Registered Nurse Anesthetist
Clinical Nurse Specialist
Counselor
Dentist
First Responder (EMS/Firefighter/Police)
Manager (e.g., CEO, Executive Director) or Administrative Staff
Nurse - LPN/RN
Nurse Practitioner or other advanced practice nurse
Optometrist
Peer Specialist/Recovery Coach
Pharmacist
Physical Therapist
Physician - MD/DO
Physician Assistant
Psychologist
Student (including medical, nurse practitioner, physician assistant, and other students)
Social Worker
Other:
What are your specialties or subspecialties? Check all that apply.
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Addiction Medicine
Addiction Psychiatry
Emergency Medicine
Family Medicine
Infectious Disease
Internal Medicine
Neurology
OB/GYN
Pain Management
Pediatrics
Psychiatry (child, adolescent, or adult)
Other
What is your current clinical practice setting(s)?
*
Community health center
Federally Qualified Health Center (FQHC)
Dental practice
Education (primary, secondary, post-secondary settings)
Emergency department
Hospital
Mental health treatment (e.g., inpatient, outpatient, residential, crisis response, community-based counseling and other services, etc.)
Office-based private practice
Pain management clinic
Pharmacy
Prenatal healthcare
Prison/Jail
Probation or parole office
State or local child protective services
State or local department of health
Substance use treatment (e.g., inpatient, detoxification, outpatient, opioid treatment program, residential, crisis response, community-based counseling and other services, etc.)
Urgent care
VA system or VA hospital
Other
What state do you practice in?
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Select One:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
I do not work in the US
Note: The following fields are optional and apply only to physicians.
By providing the following information, I agree to let my CME credits be reported to CME Passport.
Date of Birth (MM/DD/YYYY)
May 2025
May 2025
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Licensing State
Licensing ID
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