{"id":285,"date":"2020-01-07T16:01:08","date_gmt":"2020-01-07T21:01:08","guid":{"rendered":"https:\/\/nctbi.med.unc.edu\/?page_id=285"},"modified":"2020-04-22T12:18:27","modified_gmt":"2020-04-22T16:18:27","slug":"ceu-documentation-form","status":"publish","type":"page","link":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/nctbi\/provider-portal\/ceu-documentation-form\/","title":{"rendered":"Documentation of CEUs"},"content":{"rendered":"\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\"><div class=\"wp-block-group__inner-container\"><\/div><\/div>\n\n\n\n<div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\"><div class=\"wp-block-group__inner-container\"><\/div><\/div>\n\n\n\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-9d6595d7 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:33.33%\">\n<h3 class=\"wp-block-heading\"><strong>Ready to submit your CEU Documentation?<\/strong><\/h3>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>View a quick tutorial here<\/strong>!<\/h3>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:66.66%\">\n<iframe loading=\"lazy\" width=\"300\" height=\"175\" src=\"https:\/\/www.youtube.com\/embed\/ZDeu5NancEE\" frameborder=\"0\" allow=\"accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture\" allowfullscreen><\/iframe>\n<\/div>\n<\/div>\n\n\n\n<hr class=\"wp-block-separator is-style-wide\"\/>\n\n\n\n<ul class=\"wp-block-list\"><li>Requirement: 1.5 CEUs (15 contact hours) every 5 years<\/li><li>No more than 0.5 CEUs in any one category can count toward the total CEUs claimed for renewal<\/li><li>Professional development activities should pertain directly to, and enhance your knowledge of, brain injuries in the broad areas listed below<\/li><li>Activities may include, but are not limited to, workshops, webinars, TBI professional learning teams, and completion of the DPI TBI online continuing education (a document outlining topics that meet renewal requirements can be found in the Additional Documents section here)<\/li><li>Complete the fields below to document your continued professional development as it relates to brain injuries. Attach related Activity Documentation Forms or attendance certificates for each professional development activity.<\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>CEU topics to support continuing education unit (CEU) requirement<\/strong><\/h3>\n\n\n\n<p><em>In considering these options, Approved Providers should ensure that the CEU topic applies to the area of specialization<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Assessments\/Interpretation: <ul><li>Assessment of neurocognitive constructs, such as Memory, Attention, Executive Functioning, etc. <\/li><li>TBI-specific evaluation report writing <\/li><\/ul><\/li><li>Interventions\/Treatment: <ul><li>Cognitive Rehabilitation (e.g., memory interventions) <\/li><li>Injury specific treatment and intervention (e.g., stroke interventions, concussion interventions) <\/li><li>Analysis of TBI profiles and proposing appropriate interventions <\/li><li>Monitor treatment effectiveness of students with brain injuries, through the use of multiple sources of data <\/li><li>Non-school based interventions, such as pharmacological treatment, vestibular training, etc. <\/li><\/ul><\/li><li>Legislation\/Educational policies: <ul><li>Return to learn\/play <\/li><li>Special Education definition, evaluation and identification, specific to TBI <\/li><\/ul><\/li><li>Neuroanatomy\/Development: <ul><li>Brain structures\/anatomy\/development\/functions <\/li><li>Neuroanatomy and school functioning <\/li><\/ul><\/li><li>Community and School Partnerships: <ul><li>Transitioning back to school from rehabilitation <\/li><li>Community interventions available <\/li><li>Post-secondary transition, specific to students with brain injury <\/li><\/ul><\/li><li>Injury specific training: <ul><li>Specific populations\/injuries: PreK, concussion, athletes, stroke, etc. (any type of injury and their educational impact) <\/li><\/ul><\/li><li>District level PLC documentation is also acceptable: Specific to TBI<ul><li>Within any of the above categories<\/li><\/ul><\/li><\/ul>\n\n\n\n<p><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>CEU Documentation Form<\/strong><\/h3>\n\n\n\n<div class=\"wpcf7 no-js\" id=\"wpcf7-f284-o1\" lang=\"en-US\" dir=\"ltr\" data-wpcf7-id=\"284\">\n<div class=\"screen-reader-response\"><p role=\"status\" aria-live=\"polite\" aria-atomic=\"true\"><\/p> <ul><\/ul><\/div>\n<form action=\"\/index.php\/wp-json\/wp\/v2\/pages\/285#wpcf7-f284-o1\" method=\"post\" class=\"wpcf7-form init\" aria-label=\"Contact form\" enctype=\"multipart\/form-data\" novalidate=\"novalidate\" data-status=\"init\">\n<fieldset class=\"hidden-fields-container\"><input type=\"hidden\" name=\"_wpcf7\" value=\"284\" \/><input type=\"hidden\" name=\"_wpcf7_version\" value=\"6.1.5\" \/><input type=\"hidden\" name=\"_wpcf7_locale\" value=\"en_US\" \/><input type=\"hidden\" name=\"_wpcf7_unit_tag\" value=\"wpcf7-f284-o1\" \/><input type=\"hidden\" name=\"_wpcf7_container_post\" value=\"0\" \/><input type=\"hidden\" name=\"_wpcf7_posted_data_hash\" value=\"\" \/>\n<\/fieldset>\n<ul>\n\t<li>\n\t\t<p>Requirement: 1.5 CEUs (15 contact hours) every 5 years\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p>No more than 0.5 CEUs in any one category can count toward the total CEUs claimed for renewal\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p>Professional development activities should pertain directly to, and enhance your knowledge of, brain injuries in the broad areas listed below\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p>Activities may include, but are not limited to, workshops, webinars, TBI professional learning teams, and completion of the DPI TBI online curriculum\n\t\t<\/p>\n\t<\/li>\n\t<li>\n\t\t<p>Complete the fields below to document your continued professional development as it relates to brain injuries. Attach related attendance certificates for each professional development activity if available.\n\t\t<\/p>\n\t<\/li>\n<\/ul>\n<p><label> Your Name (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-name\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"your-name\" \/><\/span><br \/>\n<\/label><br \/>\n<label> Your Email (required)<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-email\"><input size=\"40\" maxlength=\"400\" class=\"wpcf7-form-control wpcf7-email wpcf7-validates-as-required wpcf7-text wpcf7-validates-as-email\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"email\" name=\"your-email\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<h3>Activity Information\n<\/h3>\n<p><label> PDF Copy of Certificate<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ceupdf\"><input size=\"40\" class=\"wpcf7-form-control wpcf7-file\" accept=\".pdf\" aria-invalid=\"false\" type=\"file\" name=\"ceupdf\" \/><\/span><br \/>\n<\/label><br \/>\n<label> Title of Activity<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"activity-title\"><input size=\"40\" maxlength=\"100\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"activity-title\" \/><\/span><br \/>\n<\/label><br \/>\n<label> Date of Activity<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"your-date\"><input class=\"wpcf7-form-control wpcf7-date wpcf7-validates-as-required wpcf7-validates-as-date\" min=\"2013-01-01\" aria-required=\"true\" aria-invalid=\"false\" value=\"2026-04-22\" type=\"date\" name=\"your-date\" \/><\/span><br \/>\n<\/label><br \/>\n<label> Presenter's Name<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"presenter\"><input size=\"40\" maxlength=\"75\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"presenter\" \/><\/span><br \/>\n<\/label><br \/>\n<label> Description of Activity<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"description-of-activity\"><textarea cols=\"40\" rows=\"10\" maxlength=\"250\" class=\"wpcf7-form-control wpcf7-textarea wpcf7-validates-as-required\" aria-required=\"true\" aria-invalid=\"false\" name=\"description-of-activity\"><\/textarea><\/span><br \/>\n<\/label>\n<\/p>\n<h4>How many clock hours were earned for this activity?\n<\/h4>\n<p><label> Clock Hours Earned<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"clock-hours-earned\"><input size=\"40\" maxlength=\"3\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required ceu-dist\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"clock-hours-earned\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<h4>How many CEUs were earned for this activity? (0.1 CEU per clock hour)\n<\/h4>\n<p><label> CEUs Earned<br \/>\n<span class=\"wpcf7-form-control-wrap\" data-name=\"ceus-earned\"><input size=\"40\" maxlength=\"3\" class=\"wpcf7-form-control wpcf7-text wpcf7-validates-as-required ceu-dist\" aria-required=\"true\" aria-invalid=\"false\" value=\"\" type=\"text\" name=\"ceus-earned\" \/><\/span><br \/>\n<\/label>\n<\/p>\n<h4>Please select the appropriate categories for these CEUs?\n<\/h4>\n<p><span class=\"wpcf7-form-control-wrap\" data-name=\"CEUcategories\"><span class=\"wpcf7-form-control wpcf7-checkbox wpcf7-validates-as-required ceu_cat\" id=\"c_cats\"><span class=\"wpcf7-list-item first\"><input type=\"checkbox\" name=\"CEUcategories[]\" value=\"Assessment Interpretation and Planning\" \/><span class=\"wpcf7-list-item-label\">Assessment Interpretation and Planning<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"CEUcategories[]\" value=\"Classroom Needs Intervention and Monitoring\" \/><span class=\"wpcf7-list-item-label\">Classroom Needs Intervention and Monitoring<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"CEUcategories[]\" value=\"Educational Policies and Decision-Making\" \/><span class=\"wpcf7-list-item-label\">Educational Policies and Decision-Making<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"CEUcategories[]\" value=\"Neuroanatomy-Development\" \/><span class=\"wpcf7-list-item-label\">Neuroanatomy-Development<\/span><\/span><span class=\"wpcf7-list-item\"><input type=\"checkbox\" name=\"CEUcategories[]\" value=\"Community Partnerships\/Collaboration\/Education\" \/><span class=\"wpcf7-list-item-label\">Community Partnerships\/Collaboration\/Education<\/span><\/span><span class=\"wpcf7-list-item last\"><input type=\"checkbox\" name=\"CEUcategories[]\" value=\"Specific Population\/Injuries\" \/><span class=\"wpcf7-list-item-label\">Specific Population\/Injuries<\/span><\/span><\/span><\/span><br \/>\n\t<text>Please describe your preferred distribution of the CEUs. If nothing is listed below, the CEUs will be distributed evenly among the selected categories. You may also make any other notes in the space below.\n <span class=\"wpcf7-form-control-wrap\" data-name=\"CEU-Explain\"><textarea cols=\"40\" rows=\"10\" maxlength=\"2000\" class=\"wpcf7-form-control wpcf7-textarea\" id=\"CEUtext\" aria-invalid=\"false\" name=\"CEU-Explain\"><\/textarea><\/span>\n\t<\/text>\n<\/p>\n<p><input class=\"wpcf7-form-control wpcf7-submit has-spinner\" type=\"submit\" value=\"Submit\" \/>\n<\/p><div class=\"wpcf7-response-output\" aria-hidden=\"true\"><\/div>\n<\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Ready to submit your CEU Documentation? View a quick tutorial here! Requirement: 1.5 CEUs (15 contact hours) every 5 years No more than 0.5 CEUs in any one category can [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":68,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"template-full-width-thin.php","meta":{"footnotes":""},"class_list":["post-285","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/pages\/285","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/comments?post=285"}],"version-history":[{"count":7,"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/pages\/285\/revisions"}],"predecessor-version":[{"id":1399,"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/pages\/285\/revisions\/1399"}],"up":[{"embeddable":true,"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/pages\/68"}],"wp:attachment":[{"href":"https:\/\/ncschoolpsychology.med.unc.edu\/index.php\/wp-json\/wp\/v2\/media?parent=285"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}