COURSE ATTENDANCE VERIFICATION

Participant's Name: Emma Holmes

State and License #: 123

Participant AGD ID#: 123

Course: test course

SPEAKERS: Emma Holmes

Educational Method: Self Study

CE Hours: -

Educational Type: Self Study

Course Date: June 26, 2025

AGD Code:

550 Practice Management and Human Resources

Verification Code: -

Authorized Signature:

PARTICIPANTS:

Please retain this document for your records. Continuing Education Credits issued
may not apply towards license renewal in all states/provinces. It is the responsibility
of each participant to verify the requirements of his/her state/provincial licensing board(s)
and to self-report their continuing education hours earned.

Keep this form for your records.

AGD Members: Dentalflix will submit attendance verification to the AGD on your behalf.
Please allow at least 30 days for documentation of participation to be added to your transcript