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• Remote Supervision Continuing Education Online Course

  • Start
    Monday, May 07, 2018
  • End
    Sunday, May 31, 2020

  Register

  

  Remote Supervision Continuing Education Online Course
  Statement of Completion and Participant Information

  Click on the Register button to complete the Statement of Completion and Participation Information form.

  
  

  Note: Please enter your name as it is printed on your License to Practice as a Dental Hygienist.

  
  

  You will be asked to provide the following information when completing the form:

  • Name (as printed on your License to Practice as a Dental Hygienist
    
  • Address
    
  • Cell Phone number
    
  • Email address (a separate verification of your email is asked as well.)
    
  • Virginia Dental Hygienist License Number
    
  • Status of ADHA Membership (and if member your ADHA Membership Number)
    
  • Component Number
    
  • Date of Completion of Online Course
    

  Upon completion of this form it will be sent to the Education Committee for processing. 

  Please allow 14 days for processing your CE certificate!

  
  

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