ICO CEE examination request form

CEE C
Course Form Please filll out all information and ccheck the app
propriate cou
urse(s) for wh
hich you wou
uld like to receive a CEE exam. Please no
ote that the C
CEE tests will be sent to th
he address prrovided below
w a few weeks followingg the event. P
Please return this form to the CE Officee. Instruction
ns for sendingg the completted examinatiions will be in
ncluded with the exams. Please note thhe return deadline on the iinstruction sh
heet. The Illinoiis College of O
Optometry will grade and process all CEEE exams. Name: ___
_____________
____________
_____________
___________ Degree: ____________________________
Address: _
_____________
____________
_____________
_________________________________________________
City: _____
____________
_________ State:________ Zip:___________ Country:_________________________ Phone: ___
____________
__________ Email:________
________________________________________________ License # aand State: ____
____________
_____________
_____________________ Check here to request test sent viaa US Mail. Unle
ess requested, all tests will b
be sent via emaail. Thomas Freddo; A Logical Appro
oach to Differrential Diagnoosis of Peri‐orbital Skin Lessions Richard London; Ey
yes That Dancce and Eyes Th
hat Can't Patricia Modica, Kelly Malloy; Th
he Many Face
es of Multiplee Sclerosis Denise
e Goodwin; O
Optic Nerve: Edema Itis Op
pathy Nathan Lighthizer; Laser Procedures for the M
Management of Glaucomaa and More Thoma
as Freddo; Systemic Evaluaation of the R
Red Eye Kimberly Reed; Con
ntroversies in Nutrition: So
orting throughh the Literatu
ure Timoth
hy Edrington, Pam Satjawaatcharaphongg; New Conta ct Lens Surgiical and Medical Managem
ment Optio
ons for Kerato
oconus A. Paul Chous, Jeffrry Gerson; Dia
abetes Nation
n: Where Are We and Where Do We Go From Here??
Elliot K
Kirstein; Criticcal Assessmen
nt of the Optiic Nerve in Gllaucoma Susan Gromacki, An
ndrew Morge
enstern; The C
Complete Maanagement off the Corneal Collagen Crosslinking (CXL) Patient. Sherry
y Bass, Jerome
e Sherman, Je
erry Rapp; Ge
enetics in Possterior Segmeent Disease Kelly T
Thomann, Nan
ncy Wong; Visual Fields: A
An Interactive Approach Kelly M
Malloy; Neuro
o Grand Roun
nds ‐ How to R
Rule Out a Craanial Nerve PPalsy William
m Townsend; Diabetes and
d the Eye: Wh
hat We Must Know Anthony DeWilde ; From Outdatted to Update
ed: AReview oof Important Clinical Trialss in Ocular Dissease from 2014 Joseph
h Shovlin, Micchael DePaolis; Corneal Inffections from
m A to Z (Acan
nthamoeba to
o Zoster)
If you have any questions, please contact Elizabeth Grantner, Illinois College of Optometry,
T 312.949.7429, F 312.949.7729, E [email protected]. Fee: $25 per course.