Continuing Education Unit Certification

Please fill in the following information and your CEU will be automatically emailed to you. Thank you for participating. We hope that you enjoyed the course.

Completion Code*
Certificate Date*
MM slash DD slash YYYY
ASHA Number*

Use 00000000 if not an ASHA member. ASHA number is required for CEU reporting.
Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Email certificate?
- No
- Yes