2025 CSRC Application for Live Continuing Education Revised

2.General Information

On behalf of the CSRC, we thank you for the opportunity to support you with your upcoming event. We kindly request you provide the following information. The Respiratory Care Board (RCB) of California establishes the criteria for CE approval by the CSRC. As outlined by the RCB section 1399.352. Criteria for Acceptability of Courses, certain requirements must be met to ensure issuance of CEs. It is the responsibility of the applicant to adhere to the complete criteria outlined.

*1.Host region (for CSRC BOD only) or facility name (for program # only or collaborations)(Required.)

*2.Primary event coordinator(Required.)

First name

Last name

Credentials and/or degree(s)

Street address

City

State

Zip

Primary phone number

3.Secondary contact person

First name

Last name

Credentials and/or degree(s)

Street address

City

State

Zip

Primary phone number

*4.Event information(Required.)

Title of event

Event date(s)

Event location (address, city, state, zip)

Number of CE hours (must have 3 behavioral objectives per CE. 4 CEs = 12 behavioral CEs)

*5.Concise description of overall event (This will be used for marketing material)(Required.)

*6.Type of education program(Required.)

In-person

In-person (program number only)

Live-online

Online

*7.All applicants are required to adhere to the criteria found at 1399.352. Criteria for Acceptability of Courses and each speaker shall be knowledgeable in the subject matter as evidenced by all of the following:(Required.)

A degree from an accredited college or university and verifiable experience in the subject, or

Teaching and/or clinical experience in the same or similar subject matter

Three behavioral objectives per CE hour

Teaching methods shall be described

*8.Will there be vendors(Required.)

Yes

*9.Learners will be informed about vendor support by (Check all that apply)(Required.)

Information provided in marketing materials

Announcement at the beginning of the program

There is no vendor support

*10.Target audience (Check all that apply)(Required.)

Respiratory Care Practitioner

Student Respiratory Care Practitioner

*11.Will you have nurses as a target audience (for Collaboration events ONLY)(Required.)

Yes

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