CE Submission Form
Submit your CE from non-PACE-approved providers* quickly and easily. Use this form to report lecture, participation/hands-on and self-instruction courses only. You can also submit your CE via fax at 312.335.3432 or email at firstname.lastname@example.org.
Before you begin, you will need:
- Your AGD membership ID and password
- The course information
- CE program provider ID
- Course title
- Completion date
- Number of hours
- Type of course
- Subject code(s)
- Letter of attendance verification or other provider verification form (this document will be accessible from your AGD transcript once your CE is posted.
If you have questions regarding the online form, download the CE Submission Guide for step-by-step directions. Requests for CE credit for teaching, publications and post-graduate residency programs (AEGD or GPR) must be submitted to the AGD Education Department via fax at 312.335.3428 or email at email@example.com.
*AGD requires organizations approved through the AGD Program Approval for Continuing Education (PACE) program to submit CE earned by AGD members directly to AGD. Hours earned from a PACE-approved organization should appear on member transcripts within 45 days of course completion. If hours from a PACE-approved organization are not listed on your transcript, contact the CE organization directly. An online list of approved AGD PACE providers is available.
CE Submission Guidelines
Submit an attendance verification form (often referred to as a certificate of completion) from the CE provider. The form(s) you submit must include the following information to receive credit:
- AGD membership ID number: Always include your six-digit AGD membership number.
- Name and address: Be sure your name is legible on all CE course verification forms.
- CE program provider name and/or AGD provider ID number: This information must be included to accurately receive credit toward the FAGD and MAGD awards or LLSR. Submit the complete name of the organization providing the course. Do not use abbreviations. Include the six-digit provider ID number, if available.
- Course date: The month, day and year the course was given must be included on the course verification form. If the course was more than one day, give both the beginning and ending dates of the course.
- Subject code: AGD subject codes correspond to various topics in dentistry.
- Title of course and instructor name: Include the title of the course and full name of the instructor .
- Hours: The actual number of clock hours spent in the course. Do not include time for lunch or registration. Indicate if the course is lecture, participation or self-instruction.
- Lecture courses: Live webinars and classroom instruction will be counted as lecture hours.
- Participation courses: The course must have a hands-on component that equals at least 30 percent of the course content.
- Self-instructional courses: Pre-recorded webinars, videos or featured exercises in peer-reviewed scientific dental journals are considered self-instruction.
- Course location: For an in-person course, include the city and state where the course took place.
Submit the following documentation to firstname.lastname@example.org for approved FAGD/MAGD/LLSR credit for the following special activities:
- Faculty positions: Letter from CODA/CDA-accredited institution confirming dates and location of full- or part-time faculty position on the institutions letterhead. Should also indicate topics taught.
- Presentations/teaching/lecturing for PACE- or CERP-approved organizations: Letter on CE organization’s letterhead confirming date, time, location, topic and length of course taught. CE organization should include its AGD provider ID number and whether or not this was the first time a lecture was presented. Include copies of program brochure, flier or listing when possible.
- Completion of CODA/CDA-accredited GPR/AEGD programs: Submit a copy of the completion certificate.
- Publications: Submit a copy of the full scientific article or copy of title page and table of contents from published textbooks.
- Military rotations: Copies of orders assigning one to a dental specialty rotation.
Credit for special activities will be awarded in accordance to current published guidelines. Contact email@example.com for more information regarding FAGD/MAGD credit for special activities. For general questions, contact AGD at 888.243.3368 or firstname.lastname@example.org.