For the Re-Opening of the Live Seminar Attendance Code Please

Request to Reopen Expired Live Seminar Code

For the re-opening of the Live Seminar Attendance Code please: 1) Fill out this form completely and legibly. 2) Provide written confirmation and approval from host organization’s coordinator **** 3) Fee: Because this process requires APhA’s technology vendor to manually open the code, APhA will assess a fee of $150 to cover expenses. a. Once form & written confirmation/approval from the host organization’s coordinator has been verified, an order will be placed on your APhA account for the $150 fee, at which time you will receive an email message requesting that you complete the transaction with your credit card. b. Once payment has been confirmed, it will take approximately 2 weeks before we notify you that your code has been re-opened. c. You will be given a short window of opportunity to redeem your code, so please do not delay.

4) Send Request to: By Email: [email protected]

APhA will not open any codes that are six months or older from the live seminar date. In addition, APhA will not open any codes for live seminars if the ACPE number associated with that seminar has expired.

Based on ACPE policies, learners have only 60 days from the date the participant completed the CPE activity to claim their credits. As it applies to the APhA training programs, this would be 60 days from the live seminar date. If the fulfillment of this request puts your timeframe outside of 60 days, you can still earn your Certificate of Achievement but will not be eligible for the live CPE credit associated with the seminar.

Program Information All Information Required

 Delivering Medication Therapy Management Services  Pharmacy-Based Immunization Delivery  Travel Health Services  Pharmacist and Patient-Centered Diabetes Care  Pharmacy-Based Cardiovascular Disease Risk Management

Date of Program Location (city/state) of Program

Attendance Code Organization which Hosted the APhA Program

Participant Information All Information Required – Items left blank will delay your request

Participant First Name Middle Name/Initial Family/Last Name

Phone Number Email Address

****PLEASE NOTE: As APhA must verify your registration, attendance/participation in the live seminar, as well as authorization from the host organization’s coordinator, we require a written communication from the Coordinator of the host company. To expedite the processing of this request, please have the Coordinator send this form to APhA on your behalf with their confirmation and approval.

****Information Required from Host Organization’s Coordinator Payment Received, if applicable Any required assessments completed successfully Attend the required amount of hours of live seminar Authorize APhA to have the code reopened

Education | American Pharmacists Association – 6/7/2016