recertification renewal - International Nurses Society on Addictions

More documents

Recommendations

Info

Name:Form A: Continuing EducationPlease print or type and avoid using abbreviations.(1)Sponsor (includingprovider no., ifapplicable)(2)Date(s) ofprogram(3)Type of program(4)Title of program(5)Program applicability toaddictions nursing practice(6)Total number ofcontact hours(points)Maximum number of points accepted for form A is 60. Total points this page1 contact hour (50-60 minutes) = 1 point.Revised July 2011
Name:Form A: Continuing EducationPlease print or type and avoid using abbreviations.(1)Sponsor (includingprovider no., ifapplicable)(2)Date(s) ofprogram(3)Type of program(4)Title of program(5)Program applicability toaddictions nursing practice(6)Total number ofcontact hours(points)Maximum number of points accepted for form A is 60. Total points this page1 contact hour (50-60 minutes) = 1 point.Revised July 2011
Page 1 and 2: RECERTIFICATION RENEWALBy 60 Points
Page 3 and 4: Certified Addictions Registered Nur
Page 5 and 6: Name:Certified Addictions Registere
Page 7: Name:Verification of Experience in
Page 11 and 12: Name:Form B: Formal Course WorkPlea
Page 13: Name:Form E: Volunteer Service---Pr

recertification renewal - International Nurses Society on Addictions

Create successful ePaper yourself

Delete template?

Save as template?