Get Surgical Experience Form - Cvma-acmv Wiki

Completing the Surgical Experience Form is an essential step for NEB candidates seeking validation of their surgical experience. This guide will walk you through the process of filling out the form accurately and effectively, ensuring all necessary information is provided.

Follow the steps to complete the Surgical Experience Form online.

1. Press the ‘Get Form’ button to access the Surgical Experience Form and open it in your designated editor.
2. In the first section, print the name of the NEB candidate as required. Ensure this is legible and accurately reflects the candidate's identity.
3. Next, the NEB candidate should sign the form where indicated. This signature confirms the authenticity of the provided information.
4. Provide the NEB candidate's identification number in the designated field to ensure proper identification within the NEB's records.
5. The validating veterinarian must fill out the section labeled 'Surgical procedure(s) performed by NEB candidate named above.' List the specific procedures observed.
6. In the subsequent field, indicate the role of the NEB candidate during the procedure, specifying whether they were the primary surgeon or an assistant.
7. Document the date when each surgical procedure was performed, ensuring it falls within the five-year requirement prior to the application to the CPE.
8. The validating veterinarian should sign the document at the designated space to affirm that they have reviewed it fully.
9. Include the signature date for the validating veterinarian to confirm the timeline of validation.
10. Print the full name of the validating veterinarian along with their license or registration number in the respective fields.
11. List the name of the licensing authority that issued the veterinarian's license, including details about the clinic name and contact information where the procedures took place.
12. Finally, ensure all sections are filled correctly, then save changes. Depending on your needs, you can download, print, or share the completed form.

Complete your Surgical Experience Form online to validate your surgical experience promptly.