CE Approver Committee Assistance Request Form - South Carolina Nurses Association

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CE Approver Committee Assistance Request Form

Please complete the form below so that we can be certain your needs are addressed by the correct individual.

You will be contacted with-in two business days.

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First Name
Last Name
Email Address
Phoneinclude area code
Have you submitted an application with SCNA CEAC before? *	Yes No
Are you requesting assistance as a (select one)? *	New Individual Activity Applicant Returning Individual Activity Applicant New Provider Unit Applicant Returning Provider Unit Applicant Need assistance for something else
Please indicate which area(s) you are requesting assistance for (select al that apply). *	Application Portal Application Process Fee Schedule Assessing Conflict of Interest Submission Deadlines Structural Capacity Education Design Process Quality Outcomes Activity Sponsorship Other (Must Specify in "Comment")
Comments
What time frame are you planning to submit your application? *	Within 14 days Within the next 30-60 days Within the next 60-90 days Within the next 6-12 months
Please indicate the type of assistance you are requesting: *	Email communication (minimal need) Phone communication (minimal to moderate needs) Video/In-person communication (moderate to heavy needs) I'm interested in a training session