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Advanced Prescribed Procedure Certification Program Checklist

To request permission to perform an advanced prescribed procedure below the dermis, the following must be submitted to the CRTO:

  • Advanced Prescribed Procedure Certification Program Checklist*
  • The certification package; and
  • a copy of the organizational policy.

Advanced Prescribed Procedure Certification Program Checklist

Procedure:

Patient Population:

Submission:

Authorization:

Curriculum: 1. The certification curriculum considers the following:

Curriculum: 2. The certification curriculum content includes:

Quality Assurance:

Records:

12 + 14 =