Live Inspections Form

LSBHI Infield Live Training Reporting Form

Trainee Information

Name of Trainee

Address

City, State, ZIP

Training Log

Total: 10 hrs

Entry 1

Date

Credit Hours

Location

Type

Trainer Initials

Entry 2

Date

Credit Hours

Location

Type

Trainer Initials

Entry 3

Date

Credit Hours

Location

Type

Trainer Initials

Entry 4

Date

Credit Hours

Location

Type

Trainer Initials

Entry 5

Date

Credit Hours

Location

Type

Trainer Initials

Entry 6

Date

Credit Hours

Location

Type

Trainer Initials

Entry 7

Date

Credit Hours

Location

Type

Trainer Initials

Entry 8

Date

Credit Hours

Location

Type

Trainer Initials

Entry 9

Date

Credit Hours

Location

Type

Trainer Initials

Entry 10

Date

Credit Hours

Location

Type

Trainer Initials

Field Trainer

Signature

Print Name

LHI LIC#

Trainer Attestations

Instructed the trainee on the monthly reporting requirements of LSBHI

Instructed the trainee on the presentation of a report to clients

Instructed the trainee on how to perform inspections in compliance with the Standards of Practice and Code of Ethics

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