On-line Application for Continuing Education Course Approval

Beginning 1/1/2024, applicants must submit all continuing education requests via the online portal. If the event occurs in more than one location or on more than one date, complete separate requests for each location.
Submission of a request does not guarantee approval. The Board’s Education Committee evaluates requests to determine if they meet continuing educational requirements.

Upload required supporting documents to request:

• Detailed timed agenda including training date(s) and time(s), subject(s), and presenter(s), instructor(s), etc.
• Course description
• Other information pertinent to the request
• Proof of attendance, if available at time of submission (examples include course certificate,
  attendance roster signed by attendees). Email proof of attendance, such as sign-in sheets, after
  the event to rehs.board@dhhs.nc.gov.
  

Course approval is good for the calendar year in which the event occurs. For courses repeated in future years, requests must be resubmitted.

Questions? Email rehs.board@dhhs.nc.gov

Continuing Education Application

Unique ID

Course Title(Required)

Continuing Education Hours requested (in quarter hour increments, include instructional hours only, not break, travel or meal times)(Required)

Course Format(Required)

In-person Only

Virtual- Remote Only

Hybrid (In-Person and Virtual/Remote)

Other

Course City and State

City North CarolinaAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State

Course Start Date(Required)

MM slash DD slash YYYY

Course End Date(Required)

MM slash DD slash YYYY

Course Provider(Required)

Attendance Verification(Required)

Certificate

Sign-In Sheets

Other

Has the board approved this request in the immediate previous year?(Required)

Yes

No

Previous Continuing Education Number

Application submitted by:(Required)

First Last

Applicant's Phone(Required)

Applicant's Email(Required)

Attendance Documentation eg. signed attendance sheets, certificate, etc. (if uploading document larger than 32 MB, email the supporting documents to rehs.board@dhhs.nc.gov)

Max. file size: 32 MB.

Agenda and Supporting Documents (if uploading document larger than 32 MB, email the supporting documents to rehs.board@dhhs.nc.gov)(Required)

Max. file size: 32 MB.

By clicking Submit below, I attest that the information provided herein to be true and correct to the best of my knowledge.

No

Yes

Comments

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