This form is to be used by licensed psychologists as a tool to document professional learning goals and demonstrate completion of required Professional Development Hours (PDH). This plan may change throughout the renewal cycle but it must be finalized before renewing a license. DORA will not retain a copy of this form. The licensee must save the completed form for their records in case they are selected for an audit of compliance. Step1: State your learning goals. An optional Reflective Self-Assessment Form is available to help create learning goals at www.colorado.gov/pacific/dora/Psychologist_CPD Learning Goal #1
Learning Goal #2
Step 2: Document completion of PDH below. Forty (40) hours of PDH per renewal period are required. Categories for PDH: Coursework Ethics Course Developing & Teaching Academic Course
Presenting Publication Editorial Review
Explanations of PDH categories may be found on the Professional Development Activity (PDA) Chart located on the Psychologist Continuing Professional Development (CPD) page: www.colorado.gov/pacific/dora/Psychologist_CPD
Enter PDH Category Example: Coursework
Provider and Contact Information Positive Psychological Interventions in Counseling
Date Completed 05/16/2018
# of Hours Completed
Documentation Attached? Yes / No
2
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Rev. 6/2017
Page 1
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Date c ompleted
Provider and Contact Information
# of Hours Competed
Documentation Attached? Yes or No
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Select Total Hours:
0
I understand that under the Colorado Mental Health Practice Act, if a licensed psychologist is unable to demonstrate his or her continued professional competence as required by section 12-43-307 C.R.S., the board may deny the applicant a license, registration, or certification or deny the reinstatement of a license, registration, or certification. Signature
Page 1 of 5. Rev 1/2017 Page 1. PSYCHOLOGIST REFLECTIVE SELF-ASSESSMENT TOOL (RSAT). Name. Last First PSY License # Date. This form is an optional reflective practice tool that identifies the foundational knowledge areas of the. psychology profession
An optional Reflective Self-Assessment Tool (RSAT) and establishment of learning. goals;. 2. Development of a Learning Plan;. 3. Execution of the Learning ...
Jun 8, 2017 - ... at meetings of local, state, regional national or. international professional or scientific organizations. Activities. may include online continuing ...
... Self Assessment Tool. (RSAT). Create Learning Plan. Your Learning Plan will provide a. framework to choose Professional. Development Activities (PDA) to.
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restful sleep, and realized my night had been a tumult of disjointed dreams that somehow all. centered around trail running, with weird trail failures and mishaps along the way. I was. overthinking this, even in my sleep. Page 3 of 19. CoreyStart-201
Page 1 of 19. July 12, 2014 Blog--Reflections on a First Trail Race. Intro. I awoke fearing I was about to do something regrettable today. I would possibly become a 'trail. nerd.' I have never been a distance runner, and certainly not on trails. Trai
