1. Fill out the application form completely. All fields are compulsory unless it is not applicable to you.
  2. Write your BCP-I certification number on each page in the space provided on the top
  3. Mention the period of re-certification
  4. Form 1: Personal Details
    • Fill out all personal details and sign along with date and place
    • Mention the hospital(s) where you have worked in the last five years
    • Take signature and stamp of HOD or HR and fill out their full name and designation
  5. Form 2: Clinical Activity
    • Fill out Clinical Activity (CPB) details in the format provided. Use one fresh sheet for each year of re-certification and mention the year on top of the page
    • You need a minimum of 40 points from this activity. If you need additional space make a copy of the blank format and fill it out. (Remember that standby carries only half a point)
  6. Form 3A: Professional Activity - conference, seminar, refresher course and in-house training
    • You need to submit details for any 2 out of the 5 re-certification years
    • Fill out a separate form for each of the 2 years and mention the year on the top of the page
    • Fill out all details completely
    • Attach a self-attested copy of the attendance certificate, mentioning your BCP-I certificate number and the year for which you are submitting the same
    • Credit will be given only for the activity indicated - passive attendance or active attendance
    • For in-house training, if there is no certificate or letter issued, take sign of the organizer / HOD for each activity.
  7. Form 3B: Professional Activity - oral presentations, posters and written publications
    • Fill out the complete details as indicated
    • For Publications: Attach a copy of published abstract or article as it appeared.
    • For Presentations: Attach a copy of program sheet showing details of presentation / poster The attendance certificate should also specify that a presentation was made
    • Fill out a separate form for each of the 2 years and mention the year on the top of the page
  8. Form 4: Summary of points earned
    • Fill out the summary of points earned for each re-certification year in the appropriate column
    • You need 40 clinical activity points per year for each of the 5 years
    • You need 20 professional activity points for any two out of the five years
  9. Page 6 – Other Details
    • Full details of Self, Chief Perfusionist & HOD (name, designation, sign & stamp as indicated)
    • Details of DD or online payment – do mention all details in the space provided
  10. Please attach a copy of your current BCP-I certificate (B&W is sufficient)

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