Renewal Application

Confirm your continuing education and pay the renewal fee.

Legal name (must match your photo ID)(Required)

Prefix First Last Suffix

Email(Required)

Phone(Required)

Mailing address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Credential(Required)

Credential number(Required)

Continuing education hours this cycle(Required)

Specialty CE hours (hyperbaric or diving)(Required)

Clinical hours this cycle (RHT only)

CE certificates (combine into one PDF)(Required)

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.

Current BLS card or license

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 10 MB.