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Participant's Name: Savannah Fitch

State and License #: MS 4082-12DH

Participant AGD ID#:

Course: A Dental Hygiene Model

SPEAKERS: Katrina Sanders

Educational Method: Self Study

CE Hours: 1

Educational Type: Self Study

Course Date: July 26, 2022

AGD Code:

550 Practice Management and Human Resources

Verification Code: HP110

Authorized Signature:

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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: Delivering Wow 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