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Application for Recertification of the Letter of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI-IR/IO)

This self-declaration form is to support the recertification of the FSRH Letter of Competence in Subdermal Contraceptive Implant Techniques (LoC SDI-IR/IO). It should be completed and submitted no sooner than 6-months prior to your recertification deadline. 

To recertify you need to confirm you have achieved the following Continuing Professional Development credits and activities over the past five years. Please refer to "How do I meet the CPD Requirements for my Letter of Competence recertification?" for guidance and requirements. 

Please refer to recertification information for details regarding recertification during the Covid-19 pandemic. 

The information you have shared on this form will be used by the relevant FSRH Committee and FSRH staff for the purposes of administration only. FSRH will keep this information securely on our systems. Our full privacy policy can be viewed here.

* Indicates a required field.

Personal Details

Please complete all details about your personal details to ensure that we can accurately record your recertification on our systems. 

As used with your MyFSRH website account.

Personal Beliefs Guidance

By checking the box below I confirm I have read the 6 principles of care as outlined in the “Guidance for those undertaking or recertifying FSRH qualifications whose personal beliefs conflict with the provision of abortion or any method of contraception” and agree to abide by them in practice. This is part of the Faculty’s conditions for recertifying a FSRH qualification.

I confirm*
CPD Requirements

I confirm I have collected at least two credits of CPD activity over the past five years. (This activity must be relevant to SDI and may be gained in one of the ways listed here.)

In addition, I confirm that I have undertaken one of the following in the past 2 years:

Option One 
SDI-IR and SDI-IO: e-SRH modules 3 and/or 14. Please register for access at the e-LFH website.

OR

Option Two
FSRH approved distance learning e.g., latest CEU SDI guidance and self-assessment questions (for non NHS professionals).

I confirm I have collected at least two credits of CPD activity over the past five years.*
I confirm I have completed Option One or Option Two in the past 2 years.*
BLS and Anaphylaxis Training
I confirm that I am up to date with Basic Life Support and Anaphylaxis Training in accordance with employer policy. *
Insertion Procedures

SDI-IR: I confirm I have completed (at least) 6 procedures (at least 1 insertion and 1 removal) in a consecutive 12-month period within 24 months of the recertification date.

SDI-IO: I confirm I have completed (at least) 6 insertions in a consecutive 12-month period within 24 months of the recertification date.

I confirm*
Data Protection Statement and Confirmation

The Data Protection Act (1998) requires organisations or agencies collecting personal data on individuals to gain their consent before collecting, storing, publishing or analysing their data.

By completing and signing this application form you are giving consent for your data to be stored on databases used by the Faculty of Sexual and Reproductive Healthcare (FSRH) of the RCOG for the purposes of administrating its membership database. All data will be treated with the strictest confidence and will only be used for legitimate FSRH purposes.

I confirm that the details on this form are correct. I understand that recertification is self-certified and that the FSRH reserves the right to audit randomly chosen applications received and that I may, therefore, be requested to provide documentary evidence of my activities.

Verification

Please click the box to indicate you are a human rather than an automated system completing this form.

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