Recertification Extension Request

An extension of the recertification deadline for extenuating circumstances may be granted for up to six months beyond the expiration date.The certificant must submit a recertification extension request electronicallyusing the form below before the certification expires. The request must include a statement of extenuating circumstances, the number of recertification hours completed, the number of work hours completed, and a detailed plan stating how all requirements will be fulfilled by the requested extended deadline.

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  • Recertification Extension Request Form



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