NOTE: Refer to the Recertification Point Structure (09-0608S) for further explanation of requirements and a listing of acceptable documentation.
The following points are being claimed on the Recertification Professional Development Reporting Form (09-0601F):
Once, during a 5-year certification cycle, a certificant may use 2 employment points towards Specialty Area Activity Points, instead of Section I. Please indiciate below if you would like to have your points allocated towards your specialty.
The information listed on this Recertification Professional Development Report (09-0601F) is accurate and reflects the professional development activities in which I have participated. If I have not provided adequate supporting documentation as defined in the Recertification Points Structure document (09-0608S), I understand that points may be deducted. I understand that ABC, or its representative(s), will verify some or all of the information contained on this form. I agree to authorize the release of this information for recertification purposes.
Upload Supporting Documentation
Upload supporting documentation for each Section.
Use the file name: Document type_Last Name_First Name_Certificant Number
For example, Supporting Documentation_Smith_John_9999