Continuing Education Reporting Form

CONTINUING EDUCATION REPORT FORM

To maintain your Eat Breathe Thrive certification, you must complete 30 hours of continuing education (CE) every three years, from the date you sign your agreement.
About You
Name:*

First NameLast Name
Email:*
example@example.com
About The Training
Certification Type:

Eat Breathe Thrive-led trainingExternal Trainings
Select the Eat Breathe Thrive-led training:

Virtual ObservationSkill Building WebinarProfessional Seminar
Select the date of the training:

MonthDayYear
Date
What is the name of the Certification / Training Program?
Please provide the Organization that offered the Certification or Training:
Training Description:
Please select all of the learning categories the training included:

Eating DisordersYoga TherapySupporting Diverse NeedsCrisis and Suicide InterventionProfessional Development
Please provide a certificate of completion that indicates the number of hours.
Upload File
Credit Hours:
Should be Empty:

CONTINUING EDUCATION REPORT FORM