CERTIFIED RURAL HEALTH CLINIC PROFESSIONAL CONTINUING EDUCATION CREDITS APPLICATION

CERTIFIED RURAL HEALTH CLINIC PROFESSIONAL CONTINUING EDUCATION CREDITS APPLICATION
Please complete all fields on the form. The timeline to approve your application could take up to 2 weeks. If approved, you will receive an approval email and your below credit card will be charged for the total amount listed in your approval email.

As a reminder:
•Applicant must be a current NARHC member
•Content must be RHC specific
•Content should align with one of the following categories: Regulatory Compliance, Billing/Coding, Cost Reporting, Professional Development, Clinic Management, and RHC Policy Updates

NOTE: Continuing education hours will only be offered in 1-hour increments at a rate of $50/hour. A maximum of 4 hours are allowed per activity.
Your Name*

First NameLast Name
Organization Name*
E-mail*
example@example.com
Phone Number*
Type of Activity*

Seminar/Summit/Conference (1 time or recurring)Webinar
Activity Title*
Activity Date and Time*
Does the activity need to be viewed live to receive credit?*

YesNo
Would you like to display this opportunity publicly on our webpage: CRHCP Maintenance Activities?*

YesNo
Link to Activity (URL)
Activity Location (if applicable)
# of Credit Hours Applied For*
(Note: maximum of 4 hours per activity at $50 per hour. If less than an hour, the fee is prorated)
Speaker Name(s) and Organization *
Please upload a copy of your agenda if available

Cancelof
LEARNING OBJECTIVES
Must list a minimum of 3 learning objectives for your activity. Topics must adhere to one or more of the following and be reflected within the learning objectives:
- Directly support the RHCs ability to deliver quality patient care.
- Assist learners in carrying out their professional responsibilities within an RHC more effectively and efficiently.
- Directly support the intent of the Rural Health Clinic Program to increase access to primary care services in rural communities.
Learning Objective #1*
Learning Objective #2*
Learning Objective #3*
Invoice Requested for Payment*

Invoice neededNo invoice needed; I can provide you with payment information immediately
Your application will be reviewed within 5 business days. Once reviewed, you will receive an email if approved. Payment information will be requested at that time if paying via credit card. If you have any questions, please email academy@narhc.org.
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