Application for CCCPLS Recertification

Pathology Laboratory Specialists CMP and Recertification Process

Upon successful certification, each member will be required to participate in the CCCPLS-CCCSLP Competency Maintenance Program (CMP). This program is mandatory for members and requires the completion of a minimum number of Continuing Education (CE) points as summarized below. See Recertification Guides for details regarding each route:

• Biopsy Processing CMP: a minimum of 8 CE points every 1 year for recertification
• Simple Dissection CMP: a minimum of 12 CE points every 1 year for recertification
• Autopsy Technician CMP: a minimum of 30 CE points every 3 years for recertification

Members who fail to fulfill the CMP requirements will have their names removed from the list of Certified Pathology Laboratory Specialists on the CCCPLS website. When a member is approaching the end of their CMP cycle, they must submit an application for recertification.

* Indicates required field

1. CCCPLS-CCCSLP Member First Name *This question is required.

2. CCCPLS-CCCSLP Member Last Name *This question is required.

3. Previous surname (if applicable)

4. CCCPLS-CCCSLP Certification (ISO) #. This number is found on your certificate. *This question is required.

5. CMP Cycle Start Date (Dec. 31 of year of certification - e.g., 12/31/2019 - format mm/dd/yyyy) *This question is required.

6. CMP Cycle End Date (Dec. 31 three years following certification for Autopsy Technician and one year for Simple Dissection and Biopsy Processing - e.g., 12/31/2022 - format mm/dd/yyyy) *This question is required.

7. Recertification Category (must match original certification category) *This question is required.

9. Current City of Practice *This question is required.

10. Employer Name

11. Practice Setting: (Hospital, Academic, Community Testing, Private, etc.) *This question is required.

12. Do you perform autopsies? *This question is required.

13. Current email address (used for all CCCPLS communications) *This question is required. This question requires a valid email address.

14. Current mailing address: *This question is required.

15. Home phone (with area code) *This question is required.

16. Work phone (with area code)

17. Questions/Comments

18. Upload completed CCCPLS-CCCSLP CE Tracking Log & Declaration Form. IT MUST BE IN PDF! *This question is required.Allowed types: pdf
Max file size: 10MB

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