CPD Council Of/for

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Professional Regulation Commission

MONITORING REPORT

CPD COUNCIL OF/FOR ____________________


Name of Provider: Provider Accreditation No: Expiration Date:

Title of the Program:

Date/s: Venue:

Credit Units Initially Given: Program Accreditation No: Date Approved:

Evaluation of Program: (Indicate the topics and time per activity, use separate sheet if needed)

Approved Program of Activities Actual Program of Activities

Remarks
Time Frame Topic Speaker Time Frame Topic Speaker Non-
Compliant
Compliant

CPDD-04
Rev. 05
June 29, 2020
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Master/s of
Total Number of Participants (Please attach the Attendance Sheets):
Ceremonies:
Observations/Findings with relevant photos/videos: Recommendations (To be presented consistent with the
Observations/Findings):

Monitored by: Concurred by:

_________________________________________ _________________________________________
(Signature Over Printed Name) (Signature Over Printed Name)
CPD Monitor CPD Provider’s Authorized Representative
_________________________ ______________________
Date and Time Date and Time

CPDD-04
Rev. 05
June 29, 2020
Page 2 of 2

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