Login or Create a New Account

Before you can register for an event or take a online quiz, you must first login or create an account. If you already have an account, enter your username and password below. If you do not already have a username and password, start by creating a profile.

Create an Account

Before you register for an event or take an online quiz you must create a user profile with Optima. Fill out the form below. Please remember the login and a password you select. Fields with an red asterisk beside them are required.

You must enter either a home or work address, and either a home or work phone number.

Salutation*:
First Name*:
Middle Initial:
Last Name*:
Name Extension:
Degree(s):*	This will appear on any certificates issued (Please abbreviate your degree e.g. MD / DO / RN / NP / PA)
Medical License Number*:
Medical License Number State*:
Home Address:
Home Suite or Unit:
Home City:
Home State/Province:
Home Zip/Postal Code:	-
Home Phone:
Work Hospital Name or Medical Group:
Work Address:
Work Suite or Unit:
Work City:
Work State/Province:
Work Zip/Postal Code:	-
Work Phone:
Work Phone Ext.:
Fax:
E-mail*:	Please enter the email address to which you would like any certificates sent.
Assistant Name:
Assistant Phone:
Username*:
Password*:
Confirm Password*:
Specialty: *Primary Activity: Office-based Hospital-based Other Send Upcoming Event Information:* To My Home Address To My Work Address Do Not Send Me Upcoming Event Information *Send All Other Materials:** To My Home Address To My Work Address