Local PACE Provider Webinar Approval Form

Organizations with local PACE approval are not automatically approved to offer live electronically-mediated events, such as webinars. Due to the COVID-19 pandemic, the AGD PACE Council is allowing locally approved providers to host such events as long as they are reported to the AGD in advance. Under no circumstances can locally approved providers award continuing education hours for self-instruction programs.

Locally approved providers will be expected to complete and submit this form before each event. The AGD reserves the right to not allow approved credit for the event if it is found that the event is being offered to participants outside a single state or province or if the organization is not following published PACE Standards when offering the event.

PACE Provider ID Number

Email Address

Telephone Number

Website Address

Official organization name of Continuing Dental Education (CDE) program provider:

Name and title of contact person to whom correspondence regarding this application should be addressed:

Check ALL boxes below to confirm

I affirm that all live electronically-mediated continuing education (CE) courses listed below will be offered in accordance to all published AGD Standards including PACE Standard XIII.

I understand that if any of the electronically-mediated events below are recorded, CE cannot be awarded to people who review the recorded versions. CE credit can only be offered to participants of live electronically-mediated events.

In accordance to PACE Standard XI: Course Records I will submit credits earned by AGD members at my courses to the AGD via the AGD website within 30 days of course completion. I understand that participants of live electronically-mediated events can be awarded LECTURE credit and that under no circumstances are locally-approved PACE Providers authorized to award SELF-INSTRUCTION credit.

Fill out the Program Approval for Continuing Education form here, and upload below.

Upload Form