1. (a) The board shall provide 3 individualized continuing education report forms as follows:

   1. (1) Form A for reporting completed continuing education hours excluding hours in:

      1. a. Pharmacology;
      2. b. Pharmacognosy;
      3. c. Acupuncure; and
      4. d. Naturopathic childbirth;
   2. (2) Form B for reporting completed continuing education hours in pharmacology and pharmacognosy; and
   3. (3) Form C for reporting completed continuing education hours in naturopathic childbirth and acupuncture.
2. (b) The applicant shall provide his or her name and license number in the space provided at the top of each form submitted.

3. (c) The information about the continuing education the renewal applicant has completed since last updating the form shall be:

   1. (1) The name of the course;
   2. (2) The location of the course;
   3. (3) The presenter or sponsor of the course;
   4. (4) The beginning and ending dates of the course;
   5. (5) The credit hours attributable to the course; and
   6. (6) The total number of credit hours being reported at the time the form is completed.

4. (d) The renewal applicant shall sign and date each form next to the following preprinted statement:

   “I certify that the above information is true and accurate and I understand that this account of completed continuing education is available to the Board of Naturopathic Examiners.”

Source. #8679, eff 7-11-06, EXPIRED: 7-11-14 New. #12176, eff 5-17-17