Vermont Physician Ebook Continuing Education

LEARNER RECORDS: SAMPLE

B

U

R

L

I

N

G T O N

V T

8

0

2

4

5

6 7 9 0 8

0

4

2

-

0 2 0 1 3 4 5

0

5

4

0

1

A

B

I

M

1

2

3 5

4 6

M

D

Medical Doctors: 042-00 + 5 numbers (Ex: 042-0012345 or 042-0001234) LICENSE NUMBER FORMATS:

Physician Assistants: 055-00 + 5 numbers (Ex: 055-0012345 or 055-0001234)

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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