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
A
K
4
5
6
A N C H O R A G E
9 9 5 0 1
6
0
1
4
5
6
7
8
9
0
M E D S 1 2 3 4
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: Allopathic Physicians (MD): 6 numbers or MEDS + 4 numbers (Ex: 123456 or MEDS1234) Physician Assistants (PA): 6 numbers or PADA + 4 numbers (Ex: 123456 or PADA1234
Osteopathic Physicians (DO): 6 numbers or MEDO + 4 numbers (Ex: 123456 or MEDO1234) Podiatrists (DPMS): 6 numbers or MEDP + 4 numbers (Ex: 123456 or MEDP1234)
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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