Loading...

Continuing Education Applications 

The CE Department is pleased to provide a way to complete and return selected CE applications by computer using interactive PDF (portable document format) files. You must have Adobe Acrobat Reader 8.0 or higher in order to view the files.  Please note that application packets for renewal purposes will no longer be mailed to program providers since all of the application materials are conveniently available online. 

You can request the following applications as PDF forms from the person listed on the right of the chart that follows, or you can do one of the following:

1. Open the form by double clicking on the desired PDF link below, fill it out online, and send it via email using the yellow submit button located in the lower right hand corner of the form.  

2. Download the form to your local computer by right-clicking on the desired PDF link, save it to your computer. Open the file using Adobe Acrobat Reader, fill it out, print it and then send it via mail or fax.

3. If you wish to send this downloaded form via email, you must have the full version of Adobe Acrobat, since the file must be saved in your local computer before you can email it.

4. Handwritten applications will no longer be accepted. 

NOTE: You must have the Adobe Acrobat Reader Version 8.0 or higher on your computer in order to view PDF files. If you do not have this free program or your version needs to be upgraded, click on the icon below. Please upgrade to the most recent version of Adobe Acrobat Reader, which you will see on the right side of the downloads page. If you have difficulty launching the PDF in your web browser, please right-click on the link and save the file to your computer. Then open the file through Adobe Acrobat Reader rather than via your browser:

Adobe Reader Icon

Once you have completed the PDF form, you can email or fax it to the person listed. You can also print a copy to mail to the AANA CE Department.

 


Payment form must accompany all applications.
 

CE Payment Form 

 


Prior Approval Forms 

 

 


1a. Application for Prior Approval 

1b. Program Outline and Documentation Form (Front)  

1c. Program Outline and Documentation Form (Back)   


Also needed for CE Programs: 

Also needed for Inservice: 

Also needed for Provider Directed Independent Study Programs: 

 

 


For more information: 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com 

 


Helpful Tips to complete the Prior Approval Application

 


2. Attendance Record 

Also need one of the following: 

 

 
For more information:

Judy Bramlett 
Fax: 847-692-7082
Email:
  jbramlett@aana.com 

 

 

 


Nonprior Approval Application forms 

 

 


Individual Application 

Also needed: 

 


For more information: 

Dale Lamitz
Fax: 847-692-7082
Email: dlamitz@aana.com 

 


New Clinical Anesthesia Experience Application 

Also needed: 

 

 


For more information: 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com 

 

 


College/University Course Application 

Also needed: 

 

 


For more information: 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com 

 

 

Publication of Original Paper Application 

Also needed: 

 

 


For more information: 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com 

 

 


Research Application 

Also needed:

 


For more information:
 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com

 

 


Group Application 

Also needed:

 

 


For more information: 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com 

 

 


Attendance Record for Nonprior Approval: Group 

 

 


For more information: 

Ann Carlson 
Fax: 847-692-7082
Email: acarlson@aana.com