wdt_ID Date(s) of Professional Activity Title of Professional Activity* Location of Professional Activity Number of Professional Activity Hours Supervisor or 2 co-workers who would be familiar with your work Email(s) of supervisor or co-workers Additional Notes UserID

Please enter your professional activity hours for recertification above.
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You can edit, delete and add requirements during the time that your certification is valid. This form is designed to help you track your professional activities for recertification, but will not be reviewed by the NTNCB until application is made for recertification.

Please read through the following notes carefully before entering your data.

*Professional Activities for Recertification: Completion of a minimum of 2000 hours of NICU-related practice over the 5-year certification period may include:

  1. Direct patient care in the NICU
  2. Teaching or clinical instruction
  3. Mentoring therapists seeking certification
  4. Professional presentations (ie. teaching to residents or nurses, conference presentations)
  5. Research; quality improvement; and/or publication
  6. NICU program development
  7. Leadership/boards/advisory teams related to the NICU
  8. Developing /training/testing new products for NICU infants, families and/or neonatal therapists

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