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Chauncey hollingberry 2026

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Click ‘Get Form’ to open the Dental Hygiene Continuing Education Audit Tracking Worksheet in the editor.
Begin by entering the 'Date' at the top of the form. This is essential for tracking your continuing education activities.
Fill in your 'Name', 'Address', 'City', 'State & Zip Code', and 'Telephone Number'. Accurate personal information ensures proper documentation.
Enter your 'License Number' and 'Email Address' for verification purposes. This information is crucial for maintaining your professional records.
In the section labeled 'Sponsor/Provider', input the name of the organization providing your continuing education courses.
For each course, list the 'Course Title' and total CE hours earned. Ensure that you keep track of all relevant courses to meet audit requirements.
Sign at the bottom of the form to verify that all information provided is accurate. If more space is needed, print additional tracking sheets as indicated.

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