Document below continuing education courses attended in the areas of swallowing and swallowing disorders within the three years immediately preceding date of this application. Applicants are required to document a minimum of 7.5 CEUs (75 hours) (A minimum of 4.5 CEUs must be from ASHA approved providers). If you attended a program with multiple sessions and mixed offerings (some related to swallowing and some not), please list only the numerical portion of the CEUs that relate to dysphagia on this form. Proof of attendance for each conference &/or ASHA CEU transcript should be attached to the application packet. (10 contact hours=1 CEU). Please list these as CEUs. Do Not list hours.
Please indicate the level of each course (Intermediate (IM), Advanced (A)). If a course is indirectly related to dysphagia and does not give a specific level, list areas covered as Other Related (OR) and do not check a level. For programs described as "other", please include a program or syllabus and mark the sections for which you are claiming CEUs. The Board expects the hours to be intermediate or advanced. Please indicate which of the following area(s) the CE addressed:
Anatomy/Physiology of Swallowing (A/P)
Evaluation of swallowing and swallowing disorders (E)
Treatment of swallowing and swallowing disorders (T)
Other related (describe how related to dysphagia) (OR)
It is the applicant’s responsibility to determine which category/categories best describe how the course related to dysphagia. If it addressed multiple areas, please estimate how many CE were devoted to each (e.g. a 2.0 CEU course might have 1.0 E and 1.0 T).