Continuing Education Request Form: In-House Counsel Program 2021

Delivery Method: Live and/or On-Demand Please read carefully. This form must be completed when your live and/or on-demand sessions are COMPLETE. Participants must fill in the requested information, sign, and submit in order to receive credit. Indicate each session you attend and the number of minutes you attended. If you attended the full session, please put in the maximum number of minutes available (number only). You will receive credit based on the actual amount of time in each session. If you do not indicate the amount of time, you will not receive credit. You MUST fill in the correct Attendance Verification Code for each session you are requesting credits for. We will also be tracking sign on and sign off times of participants for each session – live or on-demand. Credit Hours Information CLE: The maximum number of credits available, live and on-demand, for attorneys, is 11.0 credits for a 60-minute hour (including up to 1.0 ethics credit) or 13.2 credits for a 50-minute hour (including up to 1.2 ethics credit). Please note that the actual number of credits may vary from state to state. CPE: AHLA is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. The credit maximum is 13.0 hours (live and on demand). In accordance with NASBA requirements, in addition to filling out this form, you MUST fill in Attendance Verification Codes that were given at random times during the session. CCB: Compliance Certification Board has approved this program for 13.2 CCB Continuing Education Units. PLEASE NOTE: Some states are currently backlogged with processing course accreditations. Pending state approval, a certificate will be available within 7-14 business days of the time of request submission. If you do not see a certificate available in your member portal, this means that AHLA has not received an accreditation approval for this program and it is still pending. Once AHLA receives the pending approval, an email will go out stating that your certificate(s) is ready to download. The credits you receive will be based solely on the individual credit form you submit. Certificates of Completion (including any necessary additional information) will be available within 7-14 days following your request. All attendees who submit a form will receive an email with instructions on downloading their certificates through AHLA’s website. You do not have to be a member of AHLA to log on and download a certificate. If you have any questions or need further assistance, please contact Kaelyn Mooney at kmooney@americanhealthlaw.org