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Name

First Name

Last Name

Credentials

Institutional affiliation

Institution Name

Address

City

State (or country if outside the US)

Zip Code/Postal Code

Phone

If using "Other", please explain

Use the area below for any questions you have or to provide additional information.

Agreement for use of the Creighton Competency Evaluation Instrument (C-CEI©)

I understand that I have been granted permission by the creators of the C-CEI© to use the
C-CEI© for academic and/or research purposes.

I confirm that I will complete the required training prior to use of the C-CEI©. In addition, I agree that all individuals working with the C-CEI© will also complete the required training prior to using the instrument.

I agree that I will use the C-CEI© only for its intended use, and will not alter the C-CEI© in any way.

I understand that I may be asked to share results on any validity or reliability data as determined with the creators of the C-CEI©.

I AGREE