Track Your Professional CE Credits with Ease

Streamline CE credit tracking and submission for licensed professionals with this comprehensive form template for license renewal compliance.

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Licensed Professional Continuing Education Credit Tracking & Completion Form

Full Name

· · ·

Email Address

· · ·

Phone Number

· · ·

Submit

The Licensed Professional Continuing Education Credit Tracking & Completion Form is designed to help licensed professionals systematically log, document, and submit continuing education (CE) activities required for license renewal. Whether you're a nurse, attorney, engineer, or any other credentialed professional, this template ensures all your CE records are organized and audit-ready.

This form captures essential professional information including license number, license type, and issuing authority, alongside detailed course entry fields for every CE activity completed. The repeatable course section makes it easy to log multiple courses in one submission, while the built-in attestation and signature fields provide the legal certification your licensing board requires.

Ideal for HR departments managing employee license compliance, professional associations, continuing education providers, and individual practitioners, this template reduces administrative burden and minimizes the risk of errors or omissions. Use it to stay compliant, avoid disciplinary action, and confidently submit your CE records before your license expiration date.

3 Pages

14 Questions

~5min To complete

Free No credit card needed

Field types Short Text ×3 Date ×2 Full Name Email Phone Dropdown Repeatable Section Calculation Long Text termsandconditions Signature

Questions in this template

Free template

The exact questions included — customize any of them to fit your needs.

Page 1 Professional Information 8 questions

Professional Information

1 Full Name * Full Name

2 Email Address * Email

3 Phone Number Phone

4 License Number * Short Text

5 License Type * Dropdown

6 Licensing Board / Issuing Authority * Short Text

7 Current License Expiration Date * Date

8 Employer / Organization Name Short Text

Page 2 Continuing Education Course Details 2 questions

Continuing Education Course Details

Enter the details for each continuing education course or activity you are submitting for credit approval. Use the repeatable section below if you need to log multiple courses.

1 Course Entry Repeatable Section

2 Total Credits Submitted Calculation

Page 3 Attestation & Submission 4 questions

Attestation & Submission

By signing below, you certify that the continuing education activities listed in this form were completed by you and that the information provided is true and accurate to the best of your knowledge. Falsification of CE records may result in disciplinary action by your licensing board.

1 Additional Notes or Comments Long Text

2 I certify that all information provided is accurate and that I have completed all continuing education activities as described. I understand that my licensing authority may audit these records and I consent to providing additional documentation if requested. * termsandconditions

3 Signature * Signature

4 Date of Submission * Date

How to use this template

Click "Use This Template Free" to open it in the FormBuilder editor. From there you can add, remove, or reorder fields with drag-and-drop, switch themes for instant restyling, add your logo, configure email notifications, and set your success message. When ready, publish with a unique link and start collecting responses immediately.