Approved Provider Forms

Single Activity Provider Application
Multiple Activity Provider Renewal Application
MCLE Provider Credit Card Form
Activity Evaluation Form
  • For participatory activities
  • Distribute to attendees
  • Keep completed evaluation forms for one year
  • Providers must ask all of the questions on California's sample form, either by using the official California form or by including California's questions on their own evaluation form
Sample Record of Attendance
Sample Certificate of Attendance