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Clinical Mentor Request for Continuing Education

Request for PCE for Supervision of Student/Resident O&P Professionals

PCE Terms & Conditions Acknowledgement

Requirements for Participation

  • The individual holds an appropriate ABC credential to enable them to provide supervision to the students/residents present.
  • The individual has completed either (both of which are approved for ABC PCE):

                              OR

  • The individual holds an appropriate ABC credential to enable them to provide supervision to the students/residents present.
  • The individual has completed either (both of which are approved for ABC PCE):
  • The provided supervision is direct based upon the ABC’s language about supervision and provisioning.
  • The supervision is also in agreement with state licensing requirements where applicable. 

Awarding of PCE

  • For every 120 hours of supervision, the mentor may petition for 2 Category II PCE credits.
  • The mentor may not seek the award of PCE for more than 2 students and/or residents concurrently.
  • The mentor may not obtain more than 4 hours of total PCE per calendar year nor exceed 20 hours of total PCE via this pathway for each 5-year certification cycle. 
  • In order to obtain PCE, the mentor must submit this web-based form providing all the required information:
    • Their name
    • Their certification number
    • The name(s) of the students/residents being supervised
    • The level of education the students/residents have attained
    • The dates that the student/resident was being supervised
  • NCOPE reserves the right to audit each request to verify that the mentor is qualified to supervise the individual, completed appropriate mentor training, and that the student/resident case logs reflect the documented supervision. 

You will be prompted with a “Thank You” message at the end of the form and receive a confirmation e-mail upon successful submission.  If you do not receive this information, you have not successfully submitted for CE.

1. By selecting “Agree” below, you attest that you will provide honest, accurate and complete information with regard to the terms listed above.   *