Thank you for completing the Recognition and Response to Suspected Child Abuse and Neglect: Pennsylvania Act 31 Training for Healthcare Professionals.

To ensure your record is sent to the PA Department of State for license renewal, please complete the following fields:

• Your full name exactly as it appears on your license
• Your PA Board license number
• Date of birth
• The last 4 digits of your SSN

PLEASE NOTE: If you do not have an SSN, you will be prompted to fill out the Waiver of Social Security Number Verification. Upon course completion, please send a copy of your SSN Waiver and Act 31 certificate to Act31@chop.edu. These documents are necessary to receive license renewal from the Department of State.

Certificates of attendance will be issued to all professionals who complete the requirements of the course.