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执业兽医师年度活动情况报告范文
英文回答：
AnnualActivityReportforLicensedVeterinarians.
Introduction.
Licensedveterinariansarerequiredtosubmitanannual
activityreporttothestateveterinarylicensingboard.
Thisreportprovidesinformationontheveterinarians
practice,includingthetypesofanimalstreated,the
numberofpatientsseen,andthetypesofprocedures
performed.Thereportalsoincludesinformationonthe
veterinarianscontinuingeducationandprofessional
developmentactivities.
Instructions.
Theannualactivityreportshouldbesubmittedtothe
stateveterinarylicensingboardbythedeadlinespecified
bytheboard.Thereportshouldbecompleteandaccurate.
Failuretosubmitthereportontimeorsubmittingan
incompleteorinaccuratereportmayresultindisciplinary
actionbytheboard.
Section1:PracticeInformation.
Nameofveterinarian.
Addressofpractice.
Phonenumberofpractice.
Emailaddressofpractice.
Websiteaddressofpractice.
Typesofanimalstreated.
Numberofpatientsseen.
Typesofproceduresperformed.
Section2:ContinuingEducationandProfessional
Development.
Listofcontinuingeducationcoursesattended.
Numberofhoursofcontinuingeducationcompleted.
Listofprofessionaldevelopmentactivitiesattended.
Numberofhoursofprofessionaldevelopmentcompleted.
Section3:CertificationandLicensure.
Listofcertificationsheld.
Dateofcertification.
Expirationdateofcertification.
Listoflicensesheld.
Dateoflicensure.
Expirationdateoflicensure.
Section4:DisciplinaryHistory.
Listofanydisciplinaryactionstakenagainstthe
veterinarian.
Dateofdisciplinaryaction.
Reasonfordisciplinaryaction.
Signature.
Theannualactivityreportmustbesignedbyt
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