Letter of Support for 5-year Re-certification

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Complete this form to indicate your support for a Diplomate undergoing 5-year re-certification.

Email *

Your Name *

By completing this form I verify that I support the re-certification of the Diplomate named below. *

Yes

Name of the Diplomate you are supporting *

I know the Diplomate I am supporting (select one): *

Personally

By reputation

Regarding the Diplomate named above, I hereby certify that (select all that apply) *

I am not a relative or business associate

I am an academic colleague at the same institution

Required

To the best of my knowledge, this Diplomate (select all that apply): *

Has practiced, taught and/or conducted research for at least 60% time for the last 5 years.

Demonstrates satisfactory moral and ethical standing in the profession

Practices scientific, evidence-based lab animal medicine complying with animal welfare legislation

Promotes continuous improvement in the quality and standards of lab animal practice

Communicates effectively with the public and professional colleagues

Required

I have read the Diplomate's re-certification form (note, this is a requirement) *

Yes

GDPR agreement *

I consent to the storing of this information by the ECLAM website

I consent to ECLAM's use of this information in the process of conducting its core functions.

Required

5+2= *

Send me a copy of my responses.

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