AF IMT Form 2665 – Continuing Education Summary

AFFORM.NET – AF IMT Form 2665 – Continuing Education Summary – Are you wondering what an AF IMT Form 2665 is? If so, you are not alone. If you are in need of a copy of your Continuing Education Summary, you are not alone. In this article, we’ll show you how to find it, where to find it, and how to fill it out. Regardless of your level of education, you will find it in this easy-to-use online form.

Download AF IMT Form 2665 – Continuing Education Summary

Form Number AF2665
Published 30 Dec 2005
Prescribing Pub AFI41-117
File Size 33.15 KB

What is an Air Force IMT Form 2665?

The AF 422 (Intermediate Medical Test) is a required document for all active duty Air Force members. It contains information that is important for the evaluating physician to know. This document requires a letter from a civilian physician or dentist, as well as medical documentation from consultant evaluations, lab tests, and other studies. Lastly, the form must convey information in a clear, concise, and unambiguous manner.

Where Can I Find an AF IMT Form 2665?

The AF IMT Form 2665 is a legal form that has been released by the U.S. Air Force IMT on December 30, 2005. The form is used throughout the country but does not have separate filing guidelines. You can fill out the form in an online filing application or download a fillable PDF version. You must provide the SSN of the signer and contact information if the signer is not already listed.

AF IMT Form 2665 – Continuing Education Summary

The AF IMT Form 2665 – Continuous Medical Education summarizes a provider’s activities during the reporting period. The form must be completed by the provider’s director of medical education. It should also have PSVd copies of all required credentialing documents and qualitative performance. It should also include any continuing medical education credit the provider has earned. In addition to this form, providers must also complete a review form.

The documentation must include a completed ICTB, signed by the sending MTF and the ARC privileging authority, and received at least sixty days before the training. A performance evaluation must be included in the PCF. The AF Form 2665 – Continuing Education Summary should be updated annually. The ICTB and PCF should be maintained together. The PCF must also include a Primary Source Verification.

AF IMT Form 2665 Example

AF IMT Form 2665 - Page 1 AF IMT Form 2665 - Page 2

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