Nebraska Physician Ebook Continuing Education

LEARNER RECORDS: SAMPLE

F

D

O

E

J

O

H

N

1

2

3

C

H

E

R

R Y

S

T R

E

E

T

N

E

4

5

6

L I N C O L N

6 8 5 0 9

4

0

2

4

5

6

7

8

9

0

2 2 1 2 3

J

O

H

N

D

O

E

@

E

M

A

I

L

.

C

O

M

A

B

I

M

1

2

3 5

4 6

M

D

1

2

2

1

1 8

9 0

LICENSE NUMBER FORMATS: Medical Doctors (MD): 4-5 numbers Ex: 1234 or 12345

Osteopathic Physicians (DO): 2-5 numbers Ex: 123 or 1234

Physician Assistants (PA): 2-4 numbers Ex: 1234

DATA REPORTING: Federal, State, and Regulatory Agencies require disclosure of data reporting to all course participants. InforMed abides by each entity’s requirements for data reporting to attest compliance on your behalf. Reported data is governed by each entity’s confidentiality policy. To report compliance on your behalf, it’s mandatory that you must achieve a passing score and accurately fill out the learner information, activity and program evaluation, and the 90-day follow up survey. Failure to accurately provide this information may result in your data being non-reportable and subject to actions by these entities.

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