DICET Course Application

Thank you for your DICET course request.
Please take a few minutes to fill out this course form so the DICET team knows how to best serve you.
Contact Information
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Will you be the primary contact?

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Please provide contact information of the person that will be assisting you with this activity, if applicable.
Course Information
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Target Learners







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Target Learners' Specialty






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Will members of industry, such as medical devices and pharmaceuticals, be targeted learners for this program?

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Teaching Methodology







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Is this the first time this activity is being held?

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Is this or will this be a recurring activity?

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Continuing education (CE) credits to be sought



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Entity Sponsorship



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Is another institution or organization besides
Houston Methodist involved in the educational
planning or curriculum
development?

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Who will perform the planning and coordination of this event?



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Who develops the budget?



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Will funds from DICET be required?

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Will commercial support (such as educational grants or in-kind donations) be solicited?

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Will companies be allowed to purchase exhibit space?

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