PRPCE/PRC/TTT Completion Form

On behalf of the Commission on Credentialing, thank you for your service as a facilitator. Our success is predicated on people like you!

To certify participants, satisfy the records retention requirement, and provide facilitator documentation, please complete the form below. 

NAPOPP 5.10 Records Retention … The record shall contain the following for each course:

(a)names of participants; (b) dates of participation; (c) outcome; (d) evaluations completed by the instructors during the course; and (e) disposition of any related appeals. Evaluations and disposition of any appeals shall be retained for a period of one year following close of the course or appeal.

  • MM slash DD slash YYYY
  • MM slash DD slash YYYY
  • List the course attendee's name(s), and status disposition (PASS, INCOMPLETE, FAIL). Successful completion shall be defined as completing all related assignments, and performing to the standards of the modules as determined by the professional development committee. Participants shall receive an evaluation and critique within 60 days following the course.
  • Please provide any further feedback regarding the course/webinar or attendees.

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