Training Record Form Submit a Training Record [still under construction] Resident Training RecordComplete a form for each training activity during residency (classroom instruction/course, presentation given, seminar attended, meeting attended, online course completed, etc.). A total of 200 hours is required in order to submit your credentials for the board examinations. You will receive an email with the information on this form, which you should save and submit as part of your credentials application. Your instructor will automatically be sent the same email and asked to verify your completion or attendance.Please enable JavaScript in your browser to complete this form.Name of resident *FirstLastEmail *Start date of training activity *End date of training activity *Name of course/meeting/seminar *Location of course/meeting/seminar (city, country) *Name of instructor *This is the person responsible for verifying your participation in the activity, including any certificates or scores awarded.Email of instructor *EmailConfirm EmailAn email with the information on this form will automatically be sent to this address, asking for verification of your attendance/completion.Describe the competency obtained by participation in the activity, and relate to the ECLAM learning modules *ECLAM learning modules (click all that apply) *Provision of advice and veterinary services regarding transport, import and export of animalsProvision of advice regarding animal husbandry, housing and careSurveillance of health status; prevention, detection, treatment and control of disease (including zoonoses); disaster planning in case of outbreaksAdvise researchers, person(s) responsible for the project and Animal Welfare Body on study-related matters of animal health and welfare, animal models, experimental design, implementation of the 3Rs and severity assessment of proceduresRecommendations for surgical and non-surgical interventions. Provision of advice and guidance for anaesthesia, analgesia, surgery, peri-operative care and alleviation of pain, suffering and distress in relation to experimental protocolsAssess the well-being of animals and assign severity classificationKnowledge of regulations, ethics, training and facility designHow was competency assessed? (Click all that apply) *ExaminationWritten essay or assessmentCertificate awardedOtherUpload assessment Click or drag files to this area to upload. You can upload up to 2 files. Upload a copy of any documents awarded to verify participation in, or score obtained from, the activity.How many didactic training hours were awarded by this activity? *Signature of resident *Clear SignatureNameSubmit
