Required Forms
The required forms may be found by scrolling down the page, or clicking on one of the following links.
Author/Presenter/Provider Declaration
Accreditation and Renewal Checklists
Alternative Review Form
IMPORTANT NOTE: All forms have been updated on July 1, 2014. Please use the new forms for all submissions after this date.
The following forms are used with your application for CCCEP accreditation.
Disclosure
The Statement of Disclosure is to be completed by all individuals (authors, presenters, expert reviewers, provider representatives, etc. involved in the development and delivery of a learning activity.
These slides are provided as an example of disclosure slides to be used in a Live or Blended learning activity.
Expert Review
This form is used for all expert reviews, except for those using alternative (program panel) for the expert review.
This form is used only when the expert review form is completed by experts on a program advisory group composed primarily of experts in the content area.
Author/Presenter/Provider Declaration
This form is to be completed by the provider representative, authors of independent study or live learning activities and presenters of live learning activities.
Conference presenters are to complete and submit the form along with the disclosure form.
Accreditation Checklist
The following forms are provided to assist you in compiling the required documents and forms that must be submitted with your application for CCCEP accreditation.
Translation Form
The following form is used only if you are submitting a program that has been translated from French to English or English to French.
Alternative Review Form
The following form is to be used for the Alternative Review as outlined in Guideline A-07: Alternate Review Option for Larger Learning Activities or Multiple Accreditations.
This form is ONLY used by a program provider when:
- The Learning activity is a large activity (usually 10 CEUs or greater), or
- The program provider is also submitting the learning activity to be accredited by another accreditation agency.
The Program Provider must obtain approval from CCCEP prior to selecting the alternative (advisory panel) application review process.
Refer to Guideline I: Alternate Review Option for Larger Learning Activities or Multiple Accreditations for eligibility and guidelines on this option.
Mergener Formula
Competency-Mapped Accreditation Forms
- Immunization and Injections Stage 2 Application Form
- Cannabis and Patient Care in Pharmacy Stage 2 Application Form
