To submit the ADA CERP PPIP Fee Transmittal Form, you can send it to the American Dental Association via postal mail or fax. Use the following address: American Dental Association, Attn: Accounts Receivable, 211 East Chicago Avenue, Chicago, IL 60611-2678, USA. For fax submissions, use +1 312-440-2567. Ensure that you include all necessary fields and payment information to avoid delays.

Important dates for the ADA CERP PPIP Fee Transmittal Form in 2024 include submission deadlines for accreditation fees and survey returns. Make sure to check the ADA's official website for any updates or specific deadlines related to your institution's requirements.

The purpose of the ADA CERP PPIP Fee Transmittal Form is to facilitate the submission of fees required for accreditation in continuing dental education programs. By using this form, providers ensure compliance with ADA CERP guidelines, making the process organized and efficient. It is essential for maintaining the quality and recognition of continuing education courses within the dental profession.

• 1. Name of CE Provider: The official name of the continuing education provider.
• 2. Address: The physical address of the CE provider.
• 3. Contact Name and Title: The name and title of the primary contact person for the submission.
• 4. Phone: Contact phone number for questions or clarifications.
• 5. E-mail Address: Email for correspondence and confirmations.
• 6. Method of Payment: Selection of payment method including check or credit card options.
• 7. Billing Address: Billing address for credit card payments.
• 8. Signature: Signature of the authorized person submitting the form.

Failure to submit this form may result in delays in the processing of your accreditation fees, impacting the status of your continuing education programs. It is crucial to ensure that the form is completed and submitted according to the guidelines provided.

• Delayed Accreditation: Not submitting the form on time can postpone the accreditation process for your courses.
• Increased Fees: Late submissions might incur additional fees or penalties.
• Loss of Course Credits: Failure to submit might affect the eligibility for course credits towards certification.

• 1. For New Course Accreditation: Use this form when applying for accreditation for a new CE course.
• 2. For Existing Course Renewal: Necessary for renewing fees for existing accredited courses.
• 3. For Survey Submissions: Utilized when submitting surveys related to the CERP process.