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Hospital Champion Form

Congratulations! You are on your way to becoming VRCE certified. We recommend you select a Champion at your hospital to elevate your learning while completing activities and assignments in the VRCE (Veterinary Receptionist Certificate of Excellence) program. Choosing someone you trust to assist and observe your professional development at the hospital level would be best. You will present your Hospital Champion with an observation checklist for each course to ensure you have mastered the skills. Completed checklists are one of the requirements needed to graduate. You will also ask your hospital champion to monitor check-in assignments and challenges you will find in your workbook. As a reminder - if you are taking the program yourself, please choose another person to be your Champion!

Student First Name

Student Last Name

Student Phone Number

Student Email Associated with VRCE Account

Hospital Name

Hospital Address with City, State and Zip Code

Hospital Champion First Name

Hospital Champion Last Name

Hospital Champion Position

Hospital Champion Phone Number

Hospital Champion Email

Graduation Requirements: To obtain your VRCE certificate and pin, you must pass all 32 courses, submit completed workbooks and checklists for both semesters, be active within the VRCE Community, and pass both semester final exams.

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