Get 10-cprs Renewal Application (2 Pages) 042913 - Tn.gov - Tn

The 10-CPRS Renewal Application is essential for continuing your certification as a Certified Peer Recovery Specialist in Tennessee. This guide provides a clear, step-by-step approach to filling out the form accurately and submitting it on time.

Follow the steps to complete your renewal application successfully.

1. Press the ‘Get Form’ button to acquire the application form and open it in your document editor.
2. Fill in your name at the top of the form. Ensure that you write your name clearly and legibly.
3. Next, provide the date of application submission. This date should reflect the current date when you are completing the form.
4. Enter your certification number accurately as it is crucial for processing your renewal.
5. Indicate your original certification date to establish the timeline of your certification period.
6. Complete your address, including street, city, state, and ZIP code. Double-check for accuracy to avoid any communication issues.
7. Provide your phone number with the area code to ensure that you can be reached if necessary.
8. Include a valid email address as it is required for contacting you regarding your application.
9. Fill in your Social Security number to complete the identification section of the application.
10. Detail the continuing education hours you have completed. You must document at least ten hours of continuing education for renewal.
11. List the titles of training courses you have taken along with the number of hours completed for each course.
12. Calculate and indicate the total number of hours of continuing education completed.
13. Affix your signature at the bottom of the form, affirming that all the information provided is accurate to the best of your knowledge.
14. Obtain the signature of your supervising behavioral health professional and have them fill in their credentials and contact information.
15. Once the application is fully completed, save your changes and prepare to submit the form along with any required attachments, such as your continuing education certificates, by faxing to the designated number.

Ensure you complete your application online and submit all necessary documents for a smooth renewal process.