Continuing Education Credit Request Form

CE credits are only available after you complete a Dolphin training with a certified Dolphin trainer within the last 30 days. If you have not had training then you are not eligible. If you would like to receive training please contact. sales@dolphinimaging.com

Step 1. Dolphin Imaging and Management Solutions is a Continuing Education (CE) Registered Provider, under Title 16 California Code of Regulations, Section 1016. In order to received CE Credits for a Dolphin course you must have an active membership to the Dolphin Service Club, complete the following form, and submit to our corporate headquarters.

*Course Title:
(e.g.: 2013 User Meeting)

*Date Course Provided:

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*First Name:

*Last Name:

*Phone:

License#/Registration#:

*Email Address:


*Practice Name/Institution:

*Address:

*City:

*State/Province:

*Postal Code:

Country: