Qatar Council for Healthcare Practitioners

Request to Review Non-compliance with CPD Program requirements form

Instructions

Healthcare practitioners who have been deemed non-compliant with CPD cycle requirements may request a review within 30 daysof the issuance of the Notification of CPD Cycle Closure, by submitting this form to

The QCHP-AD will assemble a review panel to evaluate the evidence and rationale provided in this request; the results of which will be final and communicated to the healthcare practitioner in writing. If needed, the QCHP-AD may contact you to provide additional information.

Healthcare Practitioner Contact Details

Full Name:
CPD ePortfolio ID#
(License #): / Organization:
Phone number: / Email:

CPD Cycle Requirements – Review Request

Please indicate the reason for non-compliance provided on theNotification of CPD Cycle Closure form and provide a full rationale and accompanying evidence to demonstrate that this cycle requirement has in fact been met or provide reason(s) why more time should be granted.

To be completed by the healthcare practitioner
Non-compliance reason:
Annual requirements: healthcare practitioners must complete and document in a CPD ePortfolio a minimum of 40 CPD credits each year.
Category-specific requirements: healthcare practitioners must complete and document at least 40 credits in Category 1 and 40 credits across Category 2 and/or Category 3, in any combination.
Cycle requirements: healthcare practitioners must complete and document in their CPD ePortfolio a minimum of 80 CPD credits over each 2-year CPD cycle.
Rationale
Please provide a detailed explanation of how you have in fact met the CPD cycle requirement(s) in question or why more time should be granted to complete the requirements:
Documentation
If additional documentation was uploaded in your CPD ePortfolio to support this review request, please list the file names:

The QCHP-AD will communicate the results of this review, by completing the section indicated within this form, within 10 BUSINESS DAYS.

To be completed by the QCHP-AD
Review Panel Decision:
CPD cycle review was unsuccessful : CPD cycle remains closed, and status non-compliant
CPD cycle review was successful : additional time granted to complete cycle requirements
New CPD cycle closure date:______
CPD cycle review was successful : new CPD cycle granted
New CPD cycle date range:______
Please note that this decision is shared with the QCHP Registration Department. Per CPD Cycle Policy (MOPH/QCHP/AD/CPD/002) all healthcare practitioners in part-time or full-time practice in the State of Qatar are required to complete the annual, Category-specific, and CPD cycle requirements to maintain their registration and renewal of licensure.