CE Information

Name of Program:

Number of Hours: (do not include the time for breaks and meals)

Location of Program:

Contact:

Initial Date of Program:

Provider of Program:

Method of Presentation:

Lecture

Workshop

Seminar

Self Study (Requires a graded post-test)

All approved continuing education programs should be open to any licensed RCP that is interested in completing the program.

Category:

Speaker Name(s):

Speaker's Credentials:

CE Activity Coordinator:

Firm:

Date:

Phone Number:

Email:

Description of the program:

Outline of the program:

The target audience is:

Objectives of the lectures: After completion of the CE the individual will be able to.

Disclosure: Board Rule 21 NCAC 61 .0401 CONTINUING EDUCATION REQUIREMENTS (h) The Board shall charge twenty dollars ($20.00) per approved hour of CE with a maximum of one hundred and fifty dollars ($150.00) per application for providers of continuing education who apply for approval of continuing education programs. All CE approval expire one year from the date of approval. CE courses can be offered more than once at no additional change. The fee paid is for the application only. You will be invoiced directly upon approval. Payment must be within 30 days.

Continuing Education Approval Request Form

CE Information