The section below is provided to enter the continuing education contact hours completed throughout the calendar year. Please transfer information from the official certificate(s) of attendance. DO NOT attach copies of the attendance certificates unless specifically requested to do so by the Louisiana State Board of Examiners for Sanitarians (LSBES). Indicate the contact hours for each course and the total number of contact hours completed. Only courses approved by the Board of Examiners for Sanitarians can be used to complete the requirements.
Retain a copy of this form with your course completion certificate(s)/copy of transcript(s) for five years so that it will be available in the event of an audit. Original with signature must be submitted.
