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Application for IHS Continuing Education Course Approval


All courses submitted to IHS for approval must adhere to the IHS Course Application Requirements and Guidelines. All applications must be submitted no later than 30 days before the first offering of the course. If a course is submitted after the 30-day deadline, there is a late fee.

IHS reserves the right to reject any course application in which the content does not adhere to applicable laws and regulations, risks harm to participants and/or instructors, or contradicts generally accepted clinical practices.


Today's Date: *
 

Contact Information

Education Provider Number: *
(A unique ID number assigned by IHS identifying your company as an IHS-approved provider of continuing education.)
Contact First Name: *
Contact Last Name: *
Contact Phone: *
Contact E-mail Address: *
   

Course Information

Course Title: *
Number of CE Credits requested: *
IHS awards one (1) continuing education credit for every sixty (60) minutes of instruction. Thirty (30) minutes are equivalent to .5 credits. (e.g. 60 minutes = 1 credit, 90 minutes = 1.5 credits)
Website for more info:

Course Format: *

Check all that apply:


In Person
Online (web-based / e-learning)
Self-Study
Other (Please describe):


Target Audience: *

Select the target audience for this course (check all that appy):

Audiologists
Hearing Aid Dispensers
Other (please describe):


This course will be offered to the public
This course is for invited participants only. Please do not publicize this course in The Hearing Professional magazine or on the IHS website.


Date Course will be held: *

If you will offer the same course on numerous dates and/or in multiple locations, please indicate the date range. Only apply once for a course being offered on numerous dates and/or in multiple locations.
Start Date: *
End Date: *
(End date cannot be greater than December 31 of the current year)

Course Location: *

If you will offer the same course on numerous dates and/or in multiple locations, you only need to apply once for the course. If course will be offered in multiple locations, please list "various" under the facility name, city and state.
Facility Name where course is being hosted: *
City: *
State:

Course Overview: *



Time-ordered Agenda: *

Provide a time-ordered agenda of the course including the time, by topic, description and instructor. To add more agenda fields, click the “Insert More Agenda” button below. Add a new agenda item for each topic in the course. And, include break times and meal times in this agenda. If your agenda exceeds the 25 allowed items on this application, please email a detailed agenda to education@ihsinfo.org

Agenda 1

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 2

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 3

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 4

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 5

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 6

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 7

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 8

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 9

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 10

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 11

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 12

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 13

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 14

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 15

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 16

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 17

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 18

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 19

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 20

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 21

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 22

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 23

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 24

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):

Agenda 25

Start Time (XX:XX am) End Time (XX:XX am)
Topic
Topic Description

Instructor Instructor Job Title
Instructor Company Instructor Credentials
Instructor Biography


Learning Objectives
Learning Objectives should focus on the anticipated learner outcomes. For Example: "By attending the course, you will learn how to ______"
Learning Objective 1 Learning Objective 2 Learning Objective 3

Instructional Level: *

Fundamental (less than 2 years in practice): basic principles and concepts. Emphasis is placed on the development of fundamental knowledge, skills, and/or procedures. Previous knowledge of the content area is not essential.

Intermediate (2-10 years in practice): review of fundamentals with emphasis placed on new knowledge in application, skills, and/or procedures. Attendees will have some working knowledge and experience in this topic.

Advanced (more than 10 years in practice): in-depth discussion of the practice area. Attendees desire to be updated and expand their current knowledge of this topic.

Please choose: Fundamental Intermediate Advanced

Categories of Instruction: *
Check all that apply. Click here for a detailed list of the IHS Approved Categories of Instruction

CATEGORY I – Hearing Science
CATEGORY II – Audiometric Assessment
CATEGORY III - Audiometric Interpretation
CATEGORY IV - Patient Information and History
CATEGORY V – Hearing Instrument Systems Technology
CATEGORY VI - Earmold Impressions
CATEGORY VII – Selecting Amplification Systems
CATEGORY VIII – Instrument Fitting Techniques
CATEGORY IX – Patient Follow-up Care
CATEGORY X - Management Considerations in Instrument Dispensing
Other (Please describe):

Instruction Method: *
Check all that apply

Lecture
Open discussion
Practicum or Hands-on Instruction
Case study
Online presentation with instructor (webinar)
Video audio or online pre-recorded presentation (self-study)
Other (Please describe):



Assessment: *

Select what method you will use to assess if the learning objectives were met. Check all that apply.

Exam / Quiz / Test
Performance demonstration
Written report
Completion of a project
Self-assessment
Question and answer session
Other (Please describe):


Agreement

By submitting this application, I understand that IHS reserves the right to withdraw approved provider status and revoke course approval at any time failure to abide by these requirements:

All information submitted in any course application by a CE Provider must be true and correct and not false or misleading in any aspect.
Thoroughly read all education provider information.
Abide by the Course Approval Requirements and Guidelines document.
Agree to fees and payment policies.


For questions regarding IHS course approval email education@ihsinfo.org.