Note: If you are completing this form for someone else please use this section for their information. You may enter another individual's billing information when purchasing products.
* ALL FIELDS WITH AN ASTERISK ARE REQUIRED.
Enter your name below, EXACTLY as it should appear on your certificates.
Jr., Sr., II, III, Etc.
Since you are credentialed by ARDMS/APCA please be sure to fill out your ARDMS/APCA information in your new profile once registered so we can send your CME records directly into your CME Bank.
Choose all that apply.
We are able to electronically submit your CME to certain organizations. If yours is included please fill out one of the following two sections.
If you would like your CME reported to ARDMS / APCA please complete this section.
Please be sure you have entered your correct ARDMS / APCA number, and that you have entered your name exactly as it appears in your ARDMS / APCA record.
If you would like your CME reported to RSNA's CME Gateway please complete this section.
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Eric T. Dickinson BS RDMS, London, United Kingdom
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Phone: 802.824.4433 | Fax: 802.824.3737