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Get Form 1541 1982-2024

DESCRIPTION OF ACTIVITY Title of course meeting lecture paper self-instruction etc. AF IMT 1541 JUL 82 V1 NAME OF SPONSOR LOCATION DATES NUMBER OF CREDIT HOURS CREDIT CATEGOR 1 - 5 INCLUSIVE CARDIOPULMONARY RESUSCITATION TRAINING DATES BASIC LIFE SUPPORT V1 REFRESHER TRAINING ADVANCED CARDIAC ADVANCED TRAUMA LIFE SUPPORT INITIALS OF OFFICIAL. This is a web-optimized version of this form* Download the original full version www. usa-federal-forms. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable CREDENTIALS CONTINUING HEALTH EDUCATION TRAINING RECORD AUTHORITY 10 U*S*C. 8112 and EO 9397 PURPOSE To provide a record of an individual s participation in continuing health education activities. ROUTINE USE Used by individual practitioners to report personal continuing education accomplishments. SSAN is used for positive identification of individual and records. DISCLOSURE IS VOLUNTARY However failure to provide information may preclude awarding clinical privileges. INSTRUCTIONS Use continuously until form is completely filled out. Begin a new form and attach to old form* All forms must remain with the credentials file until it is destroyed* I. IDENTIFICATION NAME Last First Middle Initial GRADE SSAN CORPS DUTY ADDRESS PENCIL ONLY SPECIALTY PAFSC 2AFSC ACTIVITIES Conferences Seminars Meetings Lectures Publications etc* II. CATEGORY OF TRAINING Category 1 - CME activities with accredited sponsorship or cosponsorship Category 3 - Medical teaching Category 4 - Papers published exhibits etc* Category 5 - Nonsupervised CME self-instruction consultation self-assessment etc* Refer to the American Medical Association Information Booklet for Physician Recognition Award for more detailed definitions. This is a web-optimized version of this form* Download the original full version www. usa-federal-forms. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. com/download*html Convert any form into fillable savable www. fillable. com Learn how to use fillable savable forms Demos www. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable CREDENTIALS CONTINUING HEALTH EDUCATION TRAINING RECORD AUTHORITY 10 U*S*C. fillable. com/demos. html Examples www. fillable. com/examples. html Browse/search 10 s of 1000 s of U*S* federal forms converted into fillable savable CREDENTIALS CONTINUING HEALTH EDUCATION TRAINING RECORD AUTHORITY 10 U*S*C. 8112 and EO 9397 PURPOSE To provide a record of an individual s participation in continuing health education activities. 8112 and EO 9397 PURPOSE To provide a record of an individual s participation in continuing health education activities. ROUTINE USE Used by individual practitioners to report personal continuing education accomplishments. .

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