Genetic Counselor Licensure Continuing Education Declaration. CDPH 4488 - cdph ca-2026

1. Click ‘Get Form’ to open the Genetic Counselor Licensure Continuing Education Declaration in the editor.
2. Begin by entering your name, license number, and expiration date at the top of the form. Ensure all information is accurate.
3. In Part 1, list all approved NSGC Category 1 continuing education activities attended. Fill in the program date(s), sponsor, title of the program, number of CEUs earned, and contact hours for each entry.
4. Repeat the process in Part 2 for NSGC Category 2 continuing education activities. Make sure to check that you have a minimum of thirty (30) NSGC Category 1 CEU contact hours and a total of at least forty-five (45) CEU contact hours.
5. At the bottom of each page, sign and date your declaration to certify that the information provided is true and correct. Remember that each page must have a signed statement.

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