ACOG Immunization Champion Training Log
Please submit this form for every immunization-related training you attend. As an ACOG Immunization Champion, you are required to complete a minimum of 2 immunization-related trainings by 9/30/2017. You may also submit trainings you completed in 2016.
Name *
Your answer
Training Event Name *
Your answer
Training Event Date *
MM
/
DD
/
YYYY
Training Type *
Please provide 1-2 sentences about the training: Was this training useful? What did you learn? *
Your answer
Would you suggest this training to other Immunization Champions?
Please provide link to training event webpage (if available)
Your answer
Submit
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