Continuing Professional Development Partnership Inquiry Form

Thank you for your interest in working with the Greensboro Area Health Education Center (GAHEC). Please provide the following general information about the continuing professional development activity for which you wish to partner with the Greensboro AHEC.

Upon completion, please click on the [Submit] button at the bottom of the form. Our Educational Activity Review Committee will consider your request within 7 days of receipt. A representative will contact you to discuss the next steps.

Prefix, First & Last Name
Please include area code.
Include month, day and year
Include street address, city, state, zip,

Note: The practice gap is the difference between what actually occurs and what the ideal or evidence-based practice should be, or, the problem the activity is trying to solve.
Please provide specific description below of data or documentation that supports the practice gap.
Visit MyAHEC to create your personal continuing education account, print transcripts, and more. North Carolina My AHEC