# Training Record Form

| Form ID | FRM-004 | Revision | 1.0 |
|---------|---------|----------|-----|

---

## Section 1: Employee Information

| Field | Entry |
|-------|-------|
| Employee Name | |
| Employee ID | |
| Department | |
| Job Title | |

## Section 2: Training Information

| Field | Entry |
|-------|-------|
| Training Title | |
| Training Date | |
| Training Duration | |
| Trainer Name | |
| Trainer Qualification | |

### Training Type
- [ ] Initial Training
- [ ] Retraining
- [ ] Annual Competency
- [ ] Procedure Update
- [ ] Equipment Training
- [ ] Certification (NRP, PALS, etc.)

### Delivery Method
- [ ] Classroom
- [ ] On-the-Job
- [ ] Simulation
- [ ] Self-Study
- [ ] Computer-Based
- [ ] Other: ____________

## Section 3: Training Content

*(List topics covered or attach training materials)*




## Section 4: Assessment

### Assessment Method
- [ ] Written Test
- [ ] Practical Demonstration
- [ ] Verbal Assessment
- [ ] Return Demonstration
- [ ] Observation of Clinical Practice
- [ ] Simulation Performance

### Assessment Results

| Metric | Result |
|--------|--------|
| Score (if applicable) | |
| Pass/Fail | |

### Competency Validated
- [ ] Yes - Employee demonstrates competency
- [ ] No - Retraining required

## Section 5: Signatures

| Role | Name | Signature | Date |
|------|------|-----------|------|
| Trainee | | | |
| Trainer | | | |
| Supervisor | | | |

## Section 6: Follow-up (if retraining required)

| Date | Action Taken | Result |
|------|--------------|--------|
| | | |

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*Form FRM-004 Rev 1.0*